Predictors of proton pump inhibitor failure in non-erosive reflux disease: A study with impedance-pH monitoring and high-resolution manometry

BACKGROUND

Approximately one-third of gastroesophageal reflux disease (GERD) patients have symptoms resistant to proton pump inhibitor (PPI). We used the high-resolution manometry (HRM) and multichannel intraluminal impedance-pH (MII-pH) monitoring to investigate potential predictors of PPI failure in non-erosive reflux disease (NERD) patients.

METHODS

One hundred and seventeen NERD patients were included, within which there were 44 PPI failure patients. The symptomatic questionnaire GerdQ, HRM and 24-hour MII-pH monitoring were performed before PPI therapy. PPI failure was defined as persistent reflux symptoms for more than 1 day during the last week on esomeprazole (20 mg twice daily) for continuous 4 weeks. The predictors for PPI failure were investigated by multivariable logistic regression analysis.

KEY RESULTS

Proton pump inhibitor failure patients had lower body mass index (BMI) and more concomitant functional dyspepsia (FD) symptoms. PPI failure patients had a higher percentage of type I esophagogastric junction (EGJ) morphology (p = 0.005), increased EGJ augmentation (p = 0.000), higher prevalence of esophageal motility disorders (p = 0.005) and a higher ratio of negative symptom index (SI, p = 0.000). Multivariable regression analysis showed that concomitance of FD symptoms, EGJ augmentation and negative SI were independent risk factors for PPI failure in NERD.

CONCLUSIONS & INFERENCES

Approximately half of PPI failure patients were found to have esophageal motility disorders in HRM. The independent risk factors for PPI failure in NERD were concomitant FD symptoms, increased EGJ augmentation and negative SI.

Barrier function of the nasal mucosa in health and type-2 biased airway diseases

The mucosal lining of the upper airways represents the outer surface of the body to the ambient air and its contents and is prepared for it as the first line of defense. Apart from the well-described physical barrier and the mucociliary clearance, a variety of systems, including the airway microbiome, antimicrobial proteins, damage-associated molecular patterns, innate lymphoid cells, epithelial-derived cytokines and chemokines, and finally the adaptive immune system, as well as eosinophils as newly appreciated defense cells form different levels of protection against and response to any possible intruder. Of interest especially for allergic airway disease, mucosal germs might not just elicit a classical Th1/Th17-biased inflammatory response, but may directly induce a type-2 mucosal inflammation. Innovative therapeutic interventions may be possible at different levels also; however, whether modulations of the innate or adaptive immune responses will finally be more successful, and how the correction of the adaptive immune response might impact on the innate side, will be determined in the near future.

[Characteristics of social supportive network serving the older female sex workers in Qingdao]

OBJECTIVE

To overview the status of social support on older female sex workers (OFSWs) in Qingdao and to better understand the characteristics of this egocentric social support networks.

METHODS

Ucinet 6 software was used to analyze the characteristics of egocentric social networks which involving 400 OFSWs who were recruited by respondent-driven sampling (RDS) method in Qingdao during March 2014 to June. Structural equation model (SEM) was used for data analysis, fitted test and estimation.

RESULTS

A total of 400 OFSWs of Qingdao nominated 1 617 social supportive members, and the average size of egocentric social networks of OFSWs was (4.0 ± 1.5). Among all the alter egos (social support network members of the egos), 613 were female sex workers fellows, accounted for the most important part of all the social ties (37.91%). Characteristics of small size and non-relative relationships were seen more obviously among OFSWs with non-local registration and the ratings of emotional support (4.42±2.38) was significantly lower than the tangible support (5.73 ± 1.69) (P<0.05). Result of the SEM showed that homogeneity, joint strength and the network structure were significantly related to the ratings of average support. The total standard effects of which were 0.110, 0.925 and -0.069 respectively. It seemed that homogeneity can affect the degree of support, both directly and indirectly.

CONCLUSION

OFSWs in Qingdao tended to ask for social support from friends who were also female sex workers. Stronger the joint strength between egos and alters, greater the homogeneity between the two was seen. Tighter relations among the alter egos, higher degree of average social support of the egos were acquired.

Hepatitis B core-related antigen levels are associated with response to entecavir and peginterferon add-on therapy in hepatitis B e antigen-positive chronic hepatitis B patients

Hepatitis B core-related antigen (HBcrAg), a new serum marker, may be useful in monitoring chronic hepatitis B infection. HBcrAg was measured in 175 hepatitis B e antigen-positive patients treated with entecavir (ETV) with or without peginterferon (PEG-IFN) add-on therapy. Decline in HBcrAg was stronger in patients with vs. without combined response (ETV: -3.22 vs. -1.71 log U/mL, p <0.001; PEG-IFN add-on: -3.16 vs. -1.83 IU/mL, p <0.001) and in patients with vs. without hepatitis B surface antigen (HBsAg) response (ETV: -2.60 vs. -1.74 log U/mL, p <0.001; PEG-IFN add-on: -2.38 vs. -2.15 log U/mL, p = 0.31). HBcrAg was associated with combined response (adjusted odds ratio 0.3, 95% confidence interval 0.2-0.5, p <0.001), but was not superior to quantitative HBsAg (qHBsAg).

MicroRNA-211 causes ganglion cell dysplasia in congenital intestinal atresia via down-regulation of glial-derived neurotrophic factor

BACKGROUND

MicroRNAs (miRNAs) are known to be involved in normal brain functions and nervous system diseases. Some evidence have pointed to the dysregulation of miRNAs in congenital intestinal atresia. In this study, we investigated the differential expression of miRNAs and the posttranscriptional regulation of glial-derived neurotrophic factor (GDNF) by endogenous miRNA in congenital intestinal atresia.

METHODS

Quantitative real-time PCR and a Western blot were performed to determine the regulation of miRNA and GDNF in patients with congenital intestinal atresia. The results were verified in rat model of intestinal atresia and bone marrow derived stem cell BMSCs-derived into intestinal ganglion cells. The effects of miRNA and GDNF on the cell proliferation and apoptosis of isolated intestinal ganglion cells were detected with an 3-(4,5-dimethylthiazol)-2,5-diphenyl tetrazolium (MTT) assay and a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, respectively.

KEY RESULTS

Only miR-211 was greatly up-regulated in the patients with congenital intestinal atresia. The other miRNAs examined showed no change. Overexpression of miR-211 suppressed the differentiation of BMSCs into intestinal ganglion cells. In retinal ganglion cells (RGC-5 cells), miR-211 regulated the expression of GDNF. The MTT and TUNEL assays revealed that miR-211 overexpression suppressed the cell proliferation of isolated intestinal ganglion cells and that GDNF overexpression reversed the effect of pre-miR-211 on cell proliferation and apoptosis.

CONCLUSIONS & INFERENCES

Our results indicate that overexpression of miR-211 suppresses the differentiation of BMSCs into intestinal ganglion cells by directly down-regulating the expression of GDNF. The findings elucidate the role of miRNA in congenital intestinal atresia.

Copper cobalt spinel as a high performance cathode for intermediate temperature solid oxide fuel cells

CuCo₂O₄ spinel prepared via an EDTA–citric acid process was studied as a candidate solid oxide fuel cell (SOFC) cathode material at intermediate temperatures (IT).

A pH-responsive superwetting nanostructured copper mesh film for separating both water-in-oil and oil-in-water emulsions

A new pH-responsive nanostructured copper mesh film was reported for the bidirectional separation of emulsified oil/water mixtures.

The facile preparation of a carbon coated Bi2O3nanoparticle/nitrogen-doped reduced graphene oxide hybrid as a high-performance anode material for lithium-ion batteries

A hybrid of carbon coated Bi₂O₃nanoparticles distributed on nitrogen-doped reduced graphene oxide is prepared by facile thermal treatment processes.

Effects of prolonged anesthesia with dexmedetomidine, fentanyl, or remifentanil on the self-renewal of mouse embryonic stem cells

Previous study has indicated that exposure to anesthesia in early development leads to neuro-apoptosis and is followed by long-term cognitive dysfunction. Given that larger numbers of pregnant women currently receive anesthesia during the first trimester, we wanted to mimic this process in vitro using mouse embryonic stem cells (mESCs) and to explore how different anesthetics affect the self-renewal of mESCs. In the present study, mESCs were exposed to dexmedetomidine, fentanyl, or remifentanil at clinical concentrations for 48 h. The mESCs were then analyzed for cell proliferation and apoptosis. Furthermore, we used flow cytometry to analyze the cell cycle and quantitative real-time polymerase chain reaction to detect the gene expression during the cell cycle as well as the relevant stemness markers. We found that prolonged anesthesia with dexmedetomidine or fentanyl significantly inhibited mESC proliferation, with fewer cell numbers as well as decreased expression of cyclin B and cyclin E mRNA compared to that in the control group; meanwhile, p21 and RB2 gene expression was increased. Additionally, increases or decreases in the proportion of cells in the G1 and S phases, respectively, were observed in the dexmedetomidine- and fentanyl-treated groups. These anesthetics also repressed the gene expression of mESC stemness makers such as Oct4 and Sox2. However, remifentanil seemed to have no significant influence on the self-renewal of mESCs. These results demonstrated that prolonged anesthesia with dexmedetomidine or fentanyl, but not remifentanil, inhibited mESC proliferation by blocking the G1 to S transition, and repressed the maintenance of mESC stemness.

Pre-PCI medication using clopidogrel and ticagrelor in the treatment of patients with acute myocardial infarction

OBJECTIVE

This study aimed to compare preoperative treatment using clopidogrel and ticagrelor for patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI), and to investigate the efficacy and safety of these medications in the management of AMI.

PATIENTS AND METHODS

Between February 2013 and December 2014, 74 patients with AMI admitted for emergent PCI therapy were included in the study and randomly divided into two groups: study group and control group. Patients in the study group received different pre-PCI treatment with a loading dose of 180 mg ticagrelor, and those in the control group received treatments with a loading dose of 600 mg clopidogrel. After PCI procedure, all patients were orally administered 75 mg clopidogrel once a day for maintenance therapy, and patients were monitored for one week at the hospital and further followed up for one month Platelet aggregation rates (PAR) of each patient was measured before medication, at 30 min, 2h, 24h and one week after medication, respectively. PAR, thrombolysis in myocardial infarction (TIMI) flow, clinical outcomes and adverse reactions were compared between groups.

RESULTS

No significant differences were observed in PAR before treatment between groups (p>0.05), whereas PARs were significantly different after treatment between groups (p<0.05), with the efficacy of medications peaking at 2h after the treatment. In addition, PARs were significantly different between different time points after treatment (p<0.05). Evaluation of TIMI flow grade showed that in study group, 6 patients (16.22%) were grade 2 and 31 (83.78%) were grade 3 for the study group; for the control group, 11 patients (27.73%) were grade 2 and 26 (72.27%) were grade 3. No significant differences were observed in TIMI flow grades between different groups (p>0.05). No recurrence of the disease was observed, but one case (2.70%) of mucosal bleeding in the nasal cavity and four cases (10.81%) of vomiting were found in the study group. However, in the control group, four patients (10.81%) presented with recurrent disease, six patients (16.22%) experienced mucosal bleeding in the nasal cavity and 11 patients (29.73%) vomited. Significant differences were observed in the incidence of adverse events between different groups (p<0.05).

CONCLUSIONS

Compared with 600 mg clopidogrel, a loading dose of 180 mg ticagrelor could effectively inhibit platelet reactivity at the early stage of AMI, resulting in more favorable clinical outcomes and lower occurrence of adverse events and, thereby, can be used in clinical practice.

Association between IL2/IL21 and SH2B3 polymorphisms and risk of celiac disease: a meta-analysis

Celiac disease (CD) is a common autoimmune disorder characterized by heightened immunological response to ingested gluten. Certain gene polymorphisms of IL2/IL21 (rs6822844 and rs6840978) and SH2B3 (rs3184504) may influence susceptibility to CD, although the effects remain unclear. We performed a meta-analysis of the associations between rs6822844, rs6840978, and rs3184504 polymorphisms and CD risk. PubMed, EMBASE, and the China National Knowledge Infrastructure were searched. ORs and 95%CIs of each single nucleotide polymorphism (SNP) were estimated using the fixed-effect model if I(2) < 50% in the test of heterogeneity; otherwise, the random-effect model was used. Our meta-analysis included 12,986 CD cases and 28,733 controls from 16 independent samples, and the analysis of each SNP contained a subset of the total. We found that the minor allele T of both rs6822844 (T vs G, OR = 0.72, 95%CI = 0.67-0.78, P < 0.001) and rs6840978 (T vs C, OR = 0.76, 95%CI = 0.71-0.83, P < 0.001) in IL2/IL21 significantly decreased the risk of CD. However, the minor allele A of rs3184504 (A vs G, OR = 1.18, 95%CI = 1.12-1.24, P < 0.001) in SH2B3 significantly increased CD susceptibility. The estimated lambda values were 0.49, 0.50, and 0.53 for rs6822844, rs6840978, and rs3184504, respectively, suggesting that a co-dominant model of genotype effect was most appropriate for the three SNPs. Our results support associations between the three SNPs and CD and provide a strong argument for further research.

Repetitive transcranial magnetic stimulation enhances spatial learning and synaptic plasticity via the VEGF and BDNF-NMDAR pathways in a rat model of vascular dementia

This study aimed to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on learning and memory in a rat model of vascular dementia (VaD) and to analyze the associated mechanisms. Bilateral carotid artery occlusion (2-VO) was used to establish a rat model of VaD. High-frequency (5Hz) rTMS was performed on rats for four weeks. Spatial learning and memory abilities were evaluated using the Morris water maze (MWM), and synaptic plasticity in the hippocampus was assessed via long-term potentiation (LTP). Hippocampal expression of vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF) and three subunits of the N-methyl-D-aspartic acid receptor (NMDAR), NR1, NR2A and NR2B, was analyzed by Western blotting. Compared with the VaD group, escape latency was decreased (P<0.05) and the time spent in the target quadrant and the percentage of swimming distance within that quadrant were increased (P<0.05) in the rTMS group. LTP at hippocampal CA3-CA1 synapses was enhanced by rTMS (P<0.05). VEGF expression was up-regulated following 2-VO and was further increased by rTMS (P<0.05). BDNF, NR1 and NR2B expression was decreased in the VaD group and increased by rTMS (P<0.05). There were no significant differences in NR2A expression among the three groups. These results suggest that rTMS improved learning and memory in the VaD model rats via the up-regulation of VEGF, BDNF and NMDARs. In addition, NR2B may be more important than NR2A for LTP induction in the hippocampus during rTMS treatment of VaD.

Study on the correlation between the changes in intra-abdominal pressure and renal functional in the patients with abdominal compartment syndrome

OBJECTIVE

To observe the effect on renal function from increased intra-abdominal pressure.

PATIENTS AND METHODS

Sixty patients with abdominal compartment syndrome (ACS) were included in this study. Intra-abdominal pressure, mean arterial pressure (MAP) and central venous pressure (CVP) were recorded three times per day at a fixed time. Meanwhile, blood samples were collected for serum creatinine measurement and urine volume per hour was recorded.

RESULTS

The urine volume gradually decreased with the increasing intra-abdominal pressure, from 92. 6 ± 20 ml/h to 27.9 ± 20 ml/h (p < 0. 05), and the serum creatinine increased from 68.4 ± 39.9 mol/L to 249.4 ± 111.5 mol/L (p < 0. 05). The CVP increased from 0.98 ± 0.19 kPa to 1.56 ± 0.31 kPa with the increase or decrease of the MAP. The increase in intra-abdominal pressure was negatively related to the urine volume (r = -0.193, p < 0.05), and positively related to the serum creatinine (r = 0.162, p < 0.05), but not related to the MAP.

CONCLUSIONS

The increase of intra-abdominal pressure, was closely related to oliguria and increasing serum creatinine. The use of fluid resuscitation and diuretics had few effects on the recovery of the renal function. When the intra-abdominal pressure had decreased, the urine volume increased, and the serum creatinine decreased.

Regulating Underwater Oil Adhesion on Superoleophobic Copper Films through Assembling n-Alkanoic Acids

Controlling liquid adhesion on special wetting surface is significant in many practical applications. In this paper, an easy self-assembled monolayer technique was advanced to modify nanostructured copper substrates, and tunable adhesive underwater superoleophobic surfaces were prepared. The surface adhesion can be regulated by simply varying the chain length of the n-alkanoic acids, and the tunable adhesive properties can be ascribed to the combined action of surfaces nanostructures and related variation in surface chemistry. Meanwhile, the tunable ability is universal, and the oil-adhesion controllability is suitable to various oils including silicon oil, n-hexane, and chloroform. Finally, on the basis of the special tunable adhesive properties, some applications of our surfaces including droplet storage, transfer, mixing, and so on are also discussed. The paper offers a novel and simple method to prepare underwater superoleophobic surfaces with regulated adhesion, which can potentially be applied in numerous fields, for instance, biodetection, microreactors, and microfluidic devices.