Electroacupuncture alleviates affective pain in an inflammatory pain rat model

Pain has both sensory-discriminative and emotional-affective dimensions. Previous studies demonstrate that electroacupuncture (EA) alleviates the sensory dimension but do not address the affective. An inflammatory pain rat model, produced by a complete Freund adjuvant (CFA) injection into the hind paw, was combined with a conditioned place avoidance (CPA) test to determine whether EA inhibits spontaneous pain-induced affective response and, if so, to study the possibility that rostral anterior cingulate cortex (rACC) opioids underlie this effect. Male Sprague-Dawley rats (250-275 g, Harlan) were used. The rats showed place aversion (i.e. affective pain) by spending less time in a pain-paired compartment after conditioning than during a preconditioning test. Systemic non-analgesic morphine (0.5 and 1.0 mg/kg, i.p.) inhibited the affective reaction, suggesting that the affective dimension is underpinned by mechanisms different from those of the sensory dimension of pain. Morphine at 0.5 and at 1 mg/kg did not induce reward. Rats given EA treatment before pain-paired conditioning at GB 30 showed no aversion to the pain-paired compartment, indicating that EA inhibited the affective dimension. EA treatment did not produce reward or aversive effect. Intra-rACC administration of D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr amide (CTOP), a selective mu opioid receptor antagonist, but not norbinaltorphimine (nor-BNI), a selective kappa opioid receptor antagonist, blocked EA inhibition of the affective dimension. These data demonstrate that EA activates opioid receptors in the rACC to inhibit pain-induced affective responses and that EA may be an effective therapy for both the sensory-discriminative and the affective dimensions of pain.

IL-17 and IFN-γ production in peripheral blood following BCG vaccination and Mycobacterium tuberculosis infection in human

BACKGROUND

During Mycobacterium tuberculosis (Mtb) infection, cells of the immune system rely on cytokines to regulate the activity of other immune and structural cells such as IFN-gamma and IL-4. Recent studies suggest that Th17 cells secreting IL-17 may play a potential role in tuberculosis (TB) development.

AIM

To assess the effect of IL-17 on TB development, we provide a systematic review on the production of IL-17, IFN-gamma and IL-4 in infants or children vaccinated with BCG and in TB patients.

MATERIALS AND METHODS

The literature relevant with IL-17 and IFN-gamma production with or without IL-4 on human TB was retrieved from PubMed, EMBASE, Cochrane Library, BIOSIS Previews and the China Biomedicine Literature Databases (CBM) using the search terms "Interleukin-17 or Th17 cells" and "Tuberculosis". The information of included studies, the production of IL-17 and IFN-gamma responding to antigens in the peripheral blood in vitro, was independently extracted by the first two researchers and subsequently qualitatively analyzed.

RESULTS

Nine studies from a total of 226 retrieved publications met the criteria. These included studies showed that BCG vaccination induced dramatically high level of IL-17 similar to IFN-gamma; The level of IL-17 and IFN-gamma were low while IL-4 was high in patients with active TB; IL-17 and IFN-gamma had a similar trend of increase during the conversion from active to latent TB while IL-4 inclined to decrease in this process.

CONCLUSIONS

IL-17 acts as an effector molecule similar to IFN-gamma after BCG vaccination and Mtb infection to protect human against TB. The current findings do not support IL-17 as an inducer of tissue damage in TB.

Self-assembly of montmorillonite platelets during drying

This work is prompted by the quest for nanocomposites in which ordered, layered reinforcement preforms similar in structure to the arrangements seen in nacre are achieved without complex automated layer-by-layer assembly. Lamellar structures were obtained in montmorillonite films simply by slow drying without the use of additives. Clay alignment was found in films derived from suspensions of less than 0.9 vol%, ranging over a pH range of 2-11, at low drying rates and with both the natural ionic strength of the clay suspension and adjusted ionic strength. The greatest degree of order was found at the unadjusted pH and ionic strength. This method offers a potentially simple way of preparing clay preforms for polymer-clay nanocomposites at a drying rate at or below 23 nm s(-1).

Retrospective analysis of ten cases of congenital sublingual teratoid cyst

AIM

The aims of this study were to perform clinicopathological analyses of teratoid cysts of the floor of the mouth and to assess the possibility of surgical treatment.

MATERIALS AND METHODS

The incidence, manifestations, histogenesis, treatment and prognosis of 10 patients admitted to our department between April 2000 and May 2008 were reviewed.

RESULTS

Teratoid cysts occurred almost exclusively in neonates and children, and appeared as mobile, cystic solid and well-defined lesions. Because of the special location, consequences such as difficulty in feeding, breathing and even impairment in growth and development frequently occur. Results of histological examination indicated that squamous, respiratory and gastrointestinal epithelium composed the basic structure of teratoid cyst. Transonogram, CT and MRI examination were conducted, and complete surgical excision was the only treatment of choice. Usually, immediate treatment is not necessary unless the cyst obstructs the upper airway. There has been no recurrence of the lesion after surgery.

CONCLUSION

Although teratoid cyst of the floor of the mouth is a cystic disease, it affects patients to a great extent because of its special location. Therefore, early and complete excision is mandatory for good prognosis.

A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology

BACKGROUND

The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.

METHOD

We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.

RESULTS

Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.

CONCLUSIONS

This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.

Preoperative T staging of advanced gastric cancer using double contrast-enhanced ultrasound

PURPOSE

To determine the accuracy of double contrast-enhanced ultrasound (DCEUS), in which intravenous microbubbles are used together with an oral contrast agent, in the preoperative T staging of advanced gastric cancer.

MATERIALS AND METHODS

This prospective, ethics committee-approved study recruited 350 patients who gave informed consent. All had gastric cancer proved by endoscopic biopsy and underwent preoperative ultrasound staging using the TNM classification (UICC 2002). The results of DCEUS were compared with postoperative pathologic findings. The staging accuracy of oral contrast-enhanced ultrasound (OCEUS) and DCEUS were compared to each other. Sensitivity and specificity for assessing serosal involvement by DCEUS were evaluated, and the concordance of this method was analyzed using Kappa statistics.

RESULTS

The accuracies of OCEUS and DCEUS in determining the T stage of advanced gastric cancer were 75.1 % (70.4 % for T2, 79.5 % for T3, 68.1 % for T4) and 87.4 % (83.3 % for T2, 89.7 % for T3, 87.2 % for T4), respectively, and the difference between the two methods was statistically significant (χ2 = 17.364, p< 0.001). The performance of DCEUS for staging lesions in the cardia (69.81 %), fundus (85.71 %) and body (85.56 %) had lower accuracy than that of other parts (93.94 % for antrum; 92.11 % for pylorus). Sensitivity and specificity for assessing serosal involvement by DCEUS were 98.76 % and 83.33 % respectively. The reliability was almost perfect with Kappa values of 0.89 (p< 0.001) for intra-observer and 0.82 (p< 0.001) for inter-observer agreement.

CONCLUSION

DCEUS could be considered as an accurate, non-invasive, and reliable diagnostic method for preoperative staging of advanced gastric cancer.

Cytokines induced by long-term potentiation (LTP) recording: a potential explanation for the lack of correspondence between learning/memory performance and LTP

The relationship between learning/memory performance and long-term potentiation (LTP) induction is ambiguous. Although a large body of data supports a strong correspondence between learning/memory performance and LTP, many studies have also provided evidence to the contrary. In this study, we found that 2-month-old senescence-accelerated mice/prone 8 (SAMP8 mice) displayed both impaired performance in a Morris Water Maze (MWM) and enhanced LTP compared to senescence-accelerated mice/resistance 1 (SAMR1). BALB/c mice challenged with Complete Freund's Adjuvant (CFA) performed better in the shuttle-box test but displayed impaired LTP compared to intact animals. It is interesting that BALB/c mice challenged with Incomplete Freund's Adjuvant (IFA) performed better than intact animals, with no LTP impairment. Cytokine analysis showed no significant differences between the interleukin-6 (IL-6), interleukin-10 (IL-10) or TNF-α content in the intact hippocampal tissues of either the SAMR1 and SAMP8 mice or the immune-challenged BALB/c and intact animals. Further analysis demonstrated that the increase in cytokine content was higher in the hippocampal tissues used for LTP recording in the SAMR1 and CFA-challenged animals compared to the SAMP8 and intact BALB/c mice. A correlation analysis demonstrated that pro-inflammatory cytokines (IL-6 and TNF-α) displayed a negative correlation with LTP, while an anti-inflammatory cytokine (IL-10) displayed a positive correlation with LTP. These results suggest that pro-inflammatory cytokines induced by LTP manipulation in experiments (e.g., via tissue injury caused by electrode insertion) may be one of the factors contributing to the observed lack of correspondence between memory/learning ability and LTP.

Impact of atomic structure on the magnon dispersion relation: a comparison between Fe(111)/Au/W(110) and Fe(110)/W(110)

We present a combined experimental and theoretical study of the interplay between the atomic structure and the magnon excitations in low dimensional ferromagnets. Two monolayer thick Fe films on W(110) with and without a Au buffer layer are investigated. Our experiments show that adding the Au layer leads to a significant softening of the magnons. First-principles calculations confirm the experimental results revealing a strong dependency of exchange interactions on the atomic structure. It is observed that the intralayer exchange interactions increase with increasing distance between Fe layers. This unusual relationship is attributed to the complexity of the electronic structure and the contribution of different orbitals to the hybridization and exchange interaction. Our results suggest a way of tailoring magnetic excitations in low-dimensional magnetic structures.

Elevated serum concentrations of inflammatory cytokines and chemokines in patients with haemorrhagic fever with renal syndrome

OBJECTIVE

Prospective case-control study, undertaken to investigate serum cytokine and chemokine concentrations during all clinical phases and in different clinical types of haemorrhagic fever with renal syndrome (HFRS).

METHODS

Serum was collected at various disease phases from patients with HFRS (n = 35) and healthy control subjects (n = 10). Tumour necrosis factor (TNF)-α, interleukin (IL)-6, IL-4, interferon (IFN)-γ, IL-8, interferon inducible protein-10 (IP-10) and chemokine (C-C motif) ligand 5 (also known as 'regulated upon activation, normal T-cell expressed and secreted' [RANTES]) were quantified using commercial enzyme-linked immunosorbent assay kits.

RESULTS

Serum concentrations of TNF-α, IL-6, IFN-γ, IL-8, IP-10 and RANTES (but not IL-4) were significantly higher in patients compared with controls. Highest concentrations were generally found during the febrile, hypotensive and oliguric disease phases, as well as in clinically severe and critical cases.

CONCLUSION

Serum concentrations of proinflammatory cytokines and chemokines increased in line with disease severity in HFRS patients.

Spin fluctuations of paramagnetic Rh clusters revealed by x-ray magnetic circular dichroism

The magnetic moment induced on Rh atoms, forming 1.6 nm average diameter clusters, embedded in an Al(2)O(3) matrix, has been determined using x-ray magnetic circular dichroism measurements. The magnetic moment varies linearly with the applied magnetic field. At 2.3 K and under 17 T, the spin magnetic moment amounts to 0.067(2) μ(B)/Rh atom. The orbital moment does not exceed 2% of the spin moment. The susceptibility is highly temperature dependent. This is in agreement with a prediction due to Moriya and Kawabata, that in itinerant electron systems, close to the onset of magnetism, the renormalization of the magnetic susceptibility by electron correlations, leads to a Curie-like behavior.

Severity of portal hypertension and prediction of postoperative liver failure after liver resection in patients with Child–Pugh grade A cirrhosis

Background

Patients with Child–Pugh grade A cirrhosis and clinical evidence of portal hypertension are likely to develop posthepatectomy liver failure (PHLF). Whether such patients are suitable candidates for partial hepatectomy is controversial. This study explored the impact of portal venous pressure (PVP) on PHLF and the possibility of stratifying patients with Child–Pugh grade A cirrhosis for risk of PHLF using clinical data alone.

Methods

Between April 2009 and May 2011, consecutive patients who underwent partial hepatectomy for hepatocellular carcinoma and intraoperative measurement of PVP were included in this prospective study. Using signs of clinically significant portal hypertension (CSPH), patients with Child–Pugh grade A cirrhosis were subclassified into three groups: no, mild and severe CSPH. Risk factors for PHLF were subjected to univariable and multivariable analysis, and receiver operating characteristic (ROC) curve analysis.

Results

Sixty-seven (35·3 per cent) of 190 patients developed PHLF, which was persistent in 12 patients (6·3 per cent). Four patients (2·1 per cent) died from PHLF within 3 months of surgery. Multivariable analysis showed both PVP and CSPH to be independent predictors of PHLF (P &lt; 0·001). PVP values, incidence of PHLF and persistent PHLF were significantly higher in the severe CSPH group than in the other two groups (P &lt; 0·001). Severe CSPH (odds ratio 27·68, P = 0·005) and a preoperative neutrophil : lymphocyte ratio (NLR) of 2·8 or above (odds ratio 49·75, P = 0·002) were independent factors affecting the incidence of persistent PHLF.

Conclusion

The severity of CSPH, corresponding to different PVP levels, could be used to stratify patients with Child-Pugh grade A cirrhosis and to predict the incidence of PHLF. Patients with severe CSPH or a NLR of 2·8 or above were more likely to develop persistent PHLF after partial hepatectomy.

Data-driven order set generation and evaluation in the pediatric environment

Order sets as part of the Computerized Provider Order Entry (CPOE) system can improve care delivery through allowing faster and easier physician order entry guided by known best practices. This study examines current utilization patterns of order sets and "a la carte" orders in a pediatric environment with a preliminary investigation of methods to automate the creation and modification of order sets using historical ordering data. We examine the current usage of order sets associated with Asthma Minor and Appendectomy Minor patients to understand how physicians are utilizing order sets, and how order set usage is associated with the time of ordering and characteristics of order sets. K-means clustering was applied to orders to generate evidence-based order sets that are learned from historical hospital data. We demonstrate that coverage rate of order sets and ordering efficiency can be increased through modifications of existing sets and creation of new sets.

Second-harmonic generation in a laterally azo-bridged trimer ferroelectric liquid crystal: phase matching in the presence of a helicoidal structure

Optical second-harmonic generation (SHG) has been studied in a trimer smectic C* liquid crystal especially designed for nonlinear optical applications. The molecule has a long conjugated donor-acceptor unit that transversally links three parallel rod-shaped moieties. A strong SHG signal has been observed at a fundamental wavelength of 1369 nm even in the presence of the spontaneous helicoidal structure of the smectic C* phase. This unusual behavior has been interpreted as due to the existence of phase matching, in which the wave vector mismatch is compensated by the wave vector of the helix. This point has been confirmed by the study of the SHG intensity versus sample thickness and light polarization characteristics. The main coefficient of the second-order susceptibility tensor of the material has been estimated to be d(22) = 28 pm/V.