The effect of oral polyethylene glycol combined with simethicone for colonoscopy on cecal intubation rate, tolerability and acceptability : a systematic review and meta-analysis

OBJECTIVE

To assess the efficacy adjunction of oral simethicone to polyethylene glycol as bowel preparation agent on cecal intubation rate.

METHODS

We searched EMBASE, PubMed and Cochrane library for randomized controlled trials regarding simeticone plus polyethylene glycol as oral drinking agents before gastroscopy,we used the soft RevMan5.3 to perform statistical analysis and stata12.0 for publication bias.

RESULTS

12 randomized trials that met the inclusion criteria were therefore pooled into a meta-analysis, which included a total of 5,112 patients. There were no significant differences on cecal intubation rate in two groups(RR=1.0,95%CI : 0.99-1.01, P=0.93) with moderate level of evidence;Subgroups analysis of 2LPEG+ Simethicone VS 2LPEG(RR =1.0, 95% CI : 0.98,1.01), 2LPEG+ Simethicone VS 4L PEG (RR=1.00, 95% CI : 0.98,1.02), PEG+ Simethicone with bisacodyl vs PEG (RR =1.00, 95% CI : 0.99,1.02), PEG+Simethicone without bisacodyl vs PEG (RR =1.00, 95% CI : 0.98,1.02) showed no difference on cecal intubation rate.There was aslo no significant difference on cecal intubation time.Abdominal bloating incidence was lower in PEG+Simethicone group than that in PEG group (RR=0.53, 95%CI : 0.31, 0.91, P=0.02). The meta-analysis result also showed a better acceptability in PEG+Simethicone group (RR=1.28, 95% CI : 1.01, 1.49, P=0.001).

CONCLUSION

Adjunction of oral simethicone to polyethylene glycol as bowel preparation agent dose not improve cecal intubation rate on colonoscopy,but with better gastrointestinal tolerability and acceptability.

Expression of orphan GPR56 correlates with tumor progression in human epithelial ovarian cancer

G protein-coupled receptor 56 (GPR56) has been demonstrated to be a significant prognostic predictor in several types of malignances, including melanoma, glioblastoma, breast cancer, colon cancer, and pancreatic cancer. GPR56 has a putative mucin-like extracellular domain, indicating functions for this receptor in the cell-cell interactions and triggering different downstream signaling pathways responsible for regulating cell survival, proliferation, adhesion, and migration. But the expression and clinical significance of GPR56 has not been elucidated in epithelial ovarian cancer (EOC). We detected GPR56 expression by immunohistochemistry in 110 samples of ovarian serous carcinoma to explore the correlation between its expression and clinicopathologic characteristics and overall survival. As the result, we found that GPR56 expression is significantly associated with advanced FIGO stage (P = 0.01) and positive lymph node invasion (P = 0.016), and it serves as an independent unfavorable prognostic factor through univariate and multivariate analysis. GPR56 knockdown could dramatically decrease the proliferation and invasion of epithelial ovarian cancer cells through down-regulating the RhoA-GTP level and up-regulating the E-cadherin level, which indicates GPR56 could promote the progression and invasion of EOC. In conclusion, GPR56 expression was demonstrated as an independent prognostic factor in EOC, suggesting that GPR56 may play an oncogenic role through the Rho and E-cadherin pathway and GPR56 could be a novel potential drug target in EOC.

Host MyD88 signaling protects against acute graft-versus-host disease after allogeneic bone marrow transplantation

Recent experimental strategies to reduce graft-versus-host disease (GVHD) have focused largely on modifying innate immunity. Toll-like receptor (TLR)-driven myeloid differentiation primary response 88 (MyD88)-dependent signalling pathways that initiate adaptive immune function are also critical for the pathogenesis of GVHD. This study aimed to delineate the role of host MyD88 in the development of acute GVHD following fully major histocompatibility complex-mismatched allogeneic bone marrow transplantation (BMT). When myeloablated BALB/c MyD88 knock-out recipients were transplanted with C57BL/6 (B6) donor cells, they developed significantly more severe GVHD than wild-type (WT) BALB/c hosts. The increased morbidity and mortality in MyD88^-/- mice correlated with increased serum levels of lipopolysaccharide and elevated inflammatory cytokines in GVHD target organs. Additionally, MyD88 deficiency in BMT recipients led to increased donor T cell expansion and more donor CD11c⁺ cell intestinal infiltration with apoptotic cells but reduced proliferation of intestinal epithelial cells compared with that in WT BMT recipients. Decreased expression of tight junction mRNA in epithelial cells of MyD88^-/- mice suggested that MyD88 contributes to intestinal integrity. Cox-2 expression in the GVHD-targeted organs of WT mice is increased upon GVHD induction, but this enhanced expression was obviously inhibited by MyD88 deficiency. The present findings demonstrate an unexpected role for host MyD88 in preventing GVHD after allogeneic BMT.

Interactive floating full-parallax digital three-dimensional light-field display based on wavefront recomposing

Advanced three-dimensional (3D) imaging techniques can acquire high-resolution 3D biomedical and biological data, but available digital display methods show this data in restricted two dimensions. 3D light-field displays optically reconstruct realistic 3D image by carefully tailoring light fields, and a natural and comfortable 3D sense of real objects or scenes is expected. An interactive floating full-parallax 3D light-field display with all depth cues is demonstrated with 3D biomedical and biological data, which are capable of achieving high efficiency and high image quality. A compound lens-array with two pieces of lens in each lens unit is designed and fabricated to suppress the aberrations and increase the viewing angle. The optimally designed holographic functional screen is used to recompose the light distribution from the lens-array. The imaging distortion can be decreased to less than 1.9% from more than 20%. The real time interactive floating full-parallax 3D light-field image with the clear displayed depth of 30 cm can be perceived with the right geometric occlusion and smooth parallax in the viewing angle of 45°, where 9216 viewpoints are used.

Eco-friendly seeded Fe3O4-Ag nanocrystals: a new type of highly efficient and low cost catalyst for methylene blue reduction

Hybrid Fe₃O₄-Ag nanocrystals, a new type of highly efficient and reusable catalyst for methylene blue (MB) reduction, are fabricated by a novel seed deposition process. X-ray diffraction and Mössbauer spectroscopy results show that the developed iron oxides are in a pure magnetite Fe₃O₄ phase. Upon manipulating the amount of Ag seeds capsuled on the modified surfaces of Fe₃O₄ nanocrystals, the catalytic capacities on the reduction of MB can be precisely adjusted with a tunable fabrication cost control. The linear correlation of the reduced MB concentration versus reaction time catalyzed by our developed hybrid Fe₃O₄-Ag nanocrystals is coherent with pseudo first order kinetics. Importantly, with remarkable recyclability features, the hybrid Fe₃O₄-Ag nanocrystals can be easily separated by applying an external magnetic field. The tailored catalytic performances of the hybrid Fe₃O₄-Ag nanocrystals during MB reduction are attributed to the optimized dynamic electron transfer process, which dominates the electrochemical mechanism wherein the nucleophilic BH₄⁻ ions donate electrons to electrophilic organic MB through Ag seeds in a regulated amount. Such developed hybrid Fe₃O₄-Ag nanocrystals pave the way towards the mass production of highly efficient and low cost catalysts for methylene blue reduction.

Hybrid Fe₃O₄-Ag nanocrystals, a new type of highly efficient and reusable catalyst for methylene blue (MB) reduction, are fabricated by a novel seed deposition process.

Weight loss drugs and lifestyle modification: Perceptions among a diverse adult sample

OBJECTIVES

Explore how adults from diverse racial and socioeconomic backgrounds perceive the use of weight loss drugs (prescription, over-the counter, herbals and supplements) and lifestyle modification.

METHODS

Individual, face-to-face, semi-structured interviews were conducted with persons presenting to an academic hospital-affiliated outpatient pharmacy serving ethnic minorities and low income individuals.

RESULTS

Fifty persons were interviewed, including 21 African Americans, 11 Hispanics and 17 low-income individuals (annual income <$20,000), of whom 33 self-reported as overweight or obese. Ever-users (14/50) and nonusers (36/50) of weight loss drugs expressed a belief in the importance of diet and exercise, but were not necessarily doing so themselves. Fear of side effects and skepticism towards efficacy of drugs deterred use. Some expressed concern over herbal product safety; others perceived herbals as natural and safe. Drugs were often viewed as a short-cut and not a long-term weight management solution.

CONCLUSION

A range of concerns related to the safety and efficacy of weight loss drugs were expressed by this lower income, ethnically diverse population of underweight to obese adults.

PRACTICE IMPLICATIONS

There is need and opportunity for healthcare providers to provide weight loss advice and accurate information regarding the safety and efficacy of various types of weight loss approaches.

High-efficient computer-generated integral imaging based on the backward ray-tracing technique and optical reconstruction

A high-efficient computer-generated integral imaging (CGII) method is presented based on the backward ray-tracing technique. In traditional CGII methods, the total rendering time is long, because a large number of cameras are established in the virtual world. The ray origin and the ray direction for every pixel in elemental image array are calculated with the backward ray-tracing technique, and the total rendering time can be noticeably reduced. The method is suitable to create high quality integral image without the pseudoscopic problem. Real time and non-real time CGII rendering images and optical reconstruction are demonstrated, and the effectiveness is verified with different types of 3D object models. Real time optical reconstruction with 90 × 90 viewpoints and the frame rate above 40 fps for the CGII 3D display are realized without the pseudoscopic problem.

[Posterior debridement combined with atlantoaxial fusion to upper cervical tuberculosis]

Objective: To explore clinical results of posterior debridement combined with atlantoaxial fusion for upper cervical Tuberculosis. Methods: From March 2007 to April 2012, 8 patients with upper cervical Tuberculosis underwent posterior debridement combined with atlantoaxial fusion in our hospital were selected for retrospective analysis. 3 cases were males and 5 females, aged 29-65 (43.5±13.2) years. According to the pedicle destruction, using different screws (pedicle screw or laminar screw) fixation.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI) were used to evaluate neurological function and calculate improvement rate JOA score. At final follow-up, clinical efficacy was evaluated by Odom's grade. situation of internal fixation, fusion of upper cervical were assessed by imaging examination. During follow-up, complications were documented and analyzed. Results: Postoperatively 12 months, all bony fusion were achieved. Tuberculosis were reached clinical cure in 12-18 months. The JOA score increased from 10.5±2.0 preoperatively to 15.6 ±1.1 in final follow-up(P<0.05), and the NDI decreased from 29.9 ± 6.2 preoperatively to 8.6±1.6 (P<0.05). At last follow-up, according to Odom's standard, excellent were obtained in 6 cases (75.0%), good 1 cases (12.5%) and ordinary 1 case (12.5%). No severe complications was documented during follow-up. Conclusions: The treatment of posterior debridement combine with atlantoaxial fusion, and structure grafting and local anti-Tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completely removal of lesions, but also obtain strong stability, which plays an important role in the treatment of cervical tuberculosis.

[Anterior retropharyngeal debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis]

OBJECTIVE

To evaluate the clinical efficacy of anterior debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis.

METHODS

From February 2005 to February 2013, 7 patients, 3 males and 4 females, with atlantoaxial Tuberculosis underwent anterior debridement combined with posterior atlantoaxial fusion in Department of Orthopedics Zhengzhou University People's Hospital were selected.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA), neck disability index (NDI) and Frankel Classification were used to evaluate neurological function and calculate improvement rate.At final follow-up, clinical efficacy was evaluated by Odom's grade.Situation of internal fixation, fusion of upper cervical were assessed by X-ray, CT scan and MRI scan.

RESULTS

Bony fusion were achieved in 7 cases after operation in 12 months. Tuberculosis were reached clinical cure between 17 and 21 months. At follow The JOA score increased from (11.1±0.7) preoperatively to (15.3±0.5) in final follow-up(P<0.05), and the NDI decreased from (34.0±4.6) preoperatively to (10.1±1.3) in final follow-up (P<0.05). At last follow-up, according to Odom's standard, excellent were obtained in 5 cases, good 1 cases and ordinary 1 case. Frankel Classification of all cases improved from D class to E.

CONCLUSIONS

The treatment of anterior retropharyngeal debridement combine with atlantoaxial fusion, and local anti-tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completly removal of lesions, but also obtain strong stability, which plays an important role in the treatment of atlantoaxial Tuberculosis.

Increased spontaneous neuronal activity in structurally damaged cortex is correlated with early motor recovery in patients with subcortical infarction

BACKGROUND AND PURPOSE

Secondary cortical thinning and volumetric atrophy in the motor-related cortex can inhibit early functional recovery after subcortical infarction. However, the relationship between the spontaneous neuronal activity in these cortices and motor recovery in patients with focal cerebral infarct remains unknown.

METHODS

Structural magnetic resonance imaging (MRI) and resting-state functional MRI were conducted 1, 4 and 12 weeks after onset in 22 patients with an acute subcortical infarct and in 22 normal subjects. Group differences in cortical thickness and in the amplitude of low-frequency fluctuation (ALFF) in motor-related areas were evaluated, and the relationships between ALFF, cortical thickness changes and changes in the Fugl-Meyer scores of physical performance were further analyzed.

RESULTS

In patients with subcortical infarction, progressively decreasing cortical thickness was found over the observation period ipsilesionally in the primary motor cortex (PMC), supplementary motor cortex (SMC) and precuneus (all P < 0.05). Contralesionally, progressive increases in cortical thickness were detected in SMC and insula (all P < 0.05). Increases in ALFF were observed only in PMC (bilaterally) and only at 12 weeks after stroke (all P < 0.05). The cortical thickness changes in the contralesional SMC (rs = 0.483, P = 0.023) and the ALFF changes in bilateral PMC (ipsilesional, rs = 0.51, P = 0.015; contralesional, rs = 0.463, P = 0.03) were positively correlated with changes in the Fugl-Meyer scores.

CONCLUSIONS

These results suggest that increased spontaneous neuronal activity of the PMC, a region structurally damaged secondarily to ischaemic lesion, may contribute to early motor recovery in patients with subcortical infarction.

Increased expression of macrophage migration inhibitory factor in aorta of patients with coronary atherosclerosis

AIM

The aim of the present study was to investigate the changes of macrophage migration inhibitory factor (MIF) in the aorta of patients with coronary atherosclerosis and to evaluate the relationship between aortic expression levels of MIF and atherosclerotic risk factors.

METHODS

We collected discarded aortic specimens from patients (N.=36) undergoing coronary artery bypass graft surgery (CABG), and studied the presence and distribution of MIF by immunohistochemistry. The arterial tissues from 10 subjects without known atherosclerosis through the kidney donation program were taken as control group. The preoperative serum triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, lipoprotein(a), apolipoprotein A, apolipoprotein B, total bilirubin, direct bilirubin, and indirect bilirubin levels of patients were examined and the coronary angiography was performed in order to assess the severity of atherosclerotic lesions.

RESULTS

MIF was detectable in aorta from CABG patients. The aortic MIF expression was elevated in smokers, and patients with hypertension or diabetes. In addition, the aortic MIF expression was associated with the levels of triglycerides, total cholesterol, low density lipoprotein cholesterol, lipoprotein (a), apolipoprotein B, total bilirubin, direct bilirubin, indirect bilirubin and coronary severity scores in simple regression analysis. However, the expression of MIF was only correlated to coronary severity scores in multiple regression analysis.

CONCLUSION

MIF is overexpressed in aorta from patients with coronary atherosclerosis and the aortic MIF expression is correlated with the severity of coronary artery disease.

Redox regulation and flower development: a novel function for glutaredoxins

Glutaredoxins (GRXs) are small, ubiquitous oxidoreductases that have been intensively studied in E. COLI, yeast and humans. They are involved in a large variety of cellular processes and exert a crucial function in the response to oxidative stress. GRXs can reduce disulfides by way of conserved cysteines, located in conserved active site motifs. As in E. COLI, yeast, and humans, GRXs with active sites of the CPYC and CGFS type are also found in lower and higher plants, however, little has been known about their function. Surprisingly, 21 GRXs from ARABIDOPSIS THALIANA contain a novel, plant-specific CC type motif. Lately, information on the function of CC type GRXs and redox regulation, in general, is accumulating. This review focuses on recent findings indicating that GRXs, glutathione and redox regulation, in general, seem to be involved in different processes of development, so far, namely in the formation of the flower. Recent advances in EST and genome sequencing projects allowed searching for the presence of the three different types of the GRX subclasses in other evolutionary informative plant species. A comparison of the GRX subclass composition from PHYSCOMITRELLA, PINUS, ORYZA, POPULUS, and ARABIDOPSIS is presented. This analysis revealed that only two CC type GRXs exist in the bryophyte PHYSCOMITRELLA and that the CC type GRXs group expanded during the evolution of land plants. The existence of a large CC type subclass in angiosperms supports the assumption that their capability to modify target protein activity posttranslationally has been integrated into crucial plant specific processes involved in higher plant development.

Predictive value of image cytometry for diagnosis of lung cancer in heavy smokers

The Research Institute for Diagnosis and Treatment of Early Lung Cancer (RIDTELC) Lung Study was initiated to determine whether lung cancer screening by automated sputum cytometry combined with conventional sputum cytology and auto-fluorescence in addition to white light bronchoscopy could enhance the detection rate of early lung cancer. The present study analyses the initial findings to evaluate the efficiency of automated sputum cytology in predicting the diagnosis of lung cancer. In this study, malignancy grade was used as a predictive parameter for lung cancer. In total, 2,480 heavy smokers (>30 pack-yrs), aged 50-74 yrs, with no previous cancer in the last 5 yrs, received chest radiology, conventional sputum cytology and sputum cytometry screening. In total, twenty-seven lung cancers were diagnosed, representing a prevalence of 1.1%, 25 of which provided sputum samples. Positive automated sputum cytology results were seen in 176 smokers (7.2%), 10 (0.4%) of whom had severe dysplasia or higher lesions (positive results) by conventional sputum cytology examination. Out of 25 tumour cases, 20 had suspicious results using automated sputum cytology, representing 80% sensitivity. One patient out of 24 with tumours had positive results on conventional sputum cytology, representing a sensitivity of 4.2%. For all stages of squamous cell lung cancer and later stage adenocarcinoma the sensitivity of automated sputum cytology was 100%. For adenocarcinoma stage I sensitivity was 25%. In conclusion, DNA analysis of sputum slides by automated sputum cytology may be a suitable tool for the detection of early lung cancer and the characterisation of a high-risk group with pre-invasive lesions for follow-up.

In vitro interaction between silicone gel and human monocyte-macrophages

Controversy remains regarding the ability of silicone materials to induce a specific immune reaction versus a nonspecific inflammatory response. Histopathological analysis of the tissue around failed breast implants reveals chronic inflammation with silicone gel droplets either surrounded by giant cells or engulfed by macrophages, areas of fibrosis, and necrosis. Macrophages are the key cells engulfing or forming foreign body giant cells. To address the mechanisms of silicone-induced inflammation a model of human monocyte-derived macrophages (MDMs) was developed. After sonication of silicone gel, the silicone droplets were embedded in Type I collagen and used to coat glass coverslips; human MDMs were subsequently seeded on the coverslips and maintained in culture for up to 7 days. The advantage of the model was that human macrophages could be studied histologically, and cytochemically as they interacted with well-characterized silicone materials. Initial analysis of the human macrophages shows phagocytosis of the silicone gel within hours of exposure to the material. Analysis for pro-inflammatory cytokines reveals significant transient secretion of IL-1 (p < 0.01) over controls by human macrophages upon exposure to silicone gel at 24 h.

The effect of polyethylene particle phagocytosis on the viability of mature human macrophages

Macrophages are the major cell type observed in the inflammatory membrane retrieved at implant revision surgery. In this study, mature human monocyte-derived macrophages (MDM) were adapted to a previously established in vitro model to examine the influence of high-density polyethylene (HDPE) particulate (4-10 microm) on MDM viability. HDPE particles were suspended in soluble type I collagen, which subsequently was solidified on glass coverslips. Mature human macrophages, derived from differentiating peripheral blood monocytes on polystyrene for 10 days, were incubated in culture media on collagen controls and collagen-particle substrata for 31 days. Histologic analysis demonstrated that MDMs were in contact with the particles at 2 h. The majority of the particles were associated with the cells within 24 h. Based on electron microscopy, those cells associated with the particles appeared to be morphologically activated rather than necrotic or apoptotic. Assessment of cell viability revealed no differences among the groups at 24 h, but at 31 days significantly more viable cells and higher DNA values were found associated with the particle groups versus the collagen controls. The histologic results validate human mature MDMs as a clinically relevant cell type for study of the role of polyethylene particulate in aseptic loosening. The cell viability results indicate that phagocytosis of HDPE is not toxic to MDMs but in fact prolongs MDM survival. The long-lived MDMs may play a role in perpetuating chronic inflammation surrounding implants.

Differential response to chemically altered polyethylene by activated mature human monocyte-derived macrophages

Macrophages and polyethylene (PE) particulate are currently recognized as being the two common denominators in the development of chronic inflammation, periprosthetic osteolysis, and subsequent implant failure. In this study, the effect of PE particulate surface chemistry on mature human monocyte-derived macrophage (MDM) function was investigated. Virgin high-density PE (HDPE: 4-10 microm) and HDPE oxidized by irradiation, thermal and chemical treatment were characterized by FT-IR and suspended in soluble type I collagen, which was subsequently solidified on glass coverslips. Human MDMs, derived from differentiating monocytes on polystyrene for 14 days, were trypsinized and cultured on collagen-particle substrata and collagen controls for 31 days. Analysis of conditioned media collected at 24h incubation showed a significantly higher level of IL-1beta secretion in virgin HDPE over oxidized HDPE or collagen controls, and a significant inhibition of IL-6 secretion in both virgin and oxidized samples. Esterase activity was increased in the medium at a significantly higher level in the virgin HDPE versus controls with the highest activity observed in oxidized HDPE at 31 days. These results illustrate the effect of PE particle surface chemistry (oxidation) on MDM cytokine secretion and esterase activity, and highlight the need to further investigate the potential of PE surface chemistry on modulating MDM function.