Smoking, alcohol and caffeine in relation to two hormonal indicators of ovarian age during the reproductive years

OBJECTIVE

To examine whether or not cigarette smoking, alcohol and caffeine intake are related to two indicators of ovarian age-anti-Müllerian hormone (AMH) and follicle stimulating hormone (FSH).

STUDY DESIGN

Cross-sectional study of 477 women with a recent index spontaneous abortion (SA) (105 trisomic, 93 non-trisomic) or livebirth (LB) (279) with hormones measured on days 2-4 of an apparently normal menstrual cycle after the index pregnancy.

RESULTS

Current smoking is associated with about a 15% increase in median FSH (β for ln(FSH)=0.14, 95% CI 0.03,0.25). It is not significantly related to AMH (β for ln(AMH)=-0.25, 95% CI -0.56,0.06). Neither alcohol 2-7days per week nor caffeine 122-<553mg per day is independently related to AMH or FSH.

CONCLUSIONS

The observation that current smoking is associated with FSH, but not with AMH, suggests that current smoking either impairs the development of antral follicles or dysregulates the hypothalamic-pituitary-ovarian axis. The absence of an association with AMH argues against mechanisms related to accelerated follicle atresia.

[A review on the epidemiologic features of severe fever with thrombocytopenia syndrome]

Severe fever with Thrombocytopenia Syndrome (SFTS) is an emerging hemorrhagic fever disease in the rural areas of east-central China, which is caused by SFTSV-a newly discovered bunyavirus. SFTSV is most likely transmitted by tick bites but can also be transmitted within human beings. The onset of SFTS is sudden and with rapid progress, with main clinical manifestations as fever, thrombocytopenia, leucopenia and gastrointestinal and hepatorenal dysfunctions. Some patients may die from multiple organ failure, and the case fatality rate is approximately 10%. In this paper, we use the method of literature review to summarize the recent research progress of SFTS which includes the epidemic distribution characteristics, medium of transmission, host animals, transmission routes and susceptibility in the general population.

What does low-intensity rTMS do to the cerebellum?

Non-invasive stimulation of the human cerebellum, such as by transcranial magnetic stimulation (TMS), is increasingly used to investigate cerebellar function and identify potential treatment for cerebellar dysfunction. However, the effects of TMS on cerebellar neurons remain poorly defined. We applied low-intensity repetitive TMS (LI-rTMS) to the mouse cerebellum in vivo and in vitro and examined the cellular and molecular sequelae. In normal C57/Bl6 mice, 4 weeks of LI-rTMS using a complex biomimetic high-frequency stimulation (BHFS) alters Purkinje cell (PC) dendritic and spine morphology; the effects persist 4 weeks after the end of stimulation. We then evaluated whether LI-rTMS could induce climbing fibre (CF) reinnervation to denervated PCs. After unilateral pedunculotomy in adult mice and 2 weeks sham or BHFS stimulation, VGLUT2 immunohistochemistry was used to quantify CF reinnervation. In contrast to sham, LI-rTMS induced CF reinnervation to the denervated hemicerebellum. To examine potential mechanisms underlying the LI-rTMS effect, we verified that BHFS could induce CF reinnervation using our in vitro olivocerebellar explants in which denervated cerebellar tissue is co-cultured adjacent to intact cerebella and treated with brain-derived neurotrophic factor (BDNF) (as a positive control), sham or LI-rTMS for 2 weeks. Compared with sham, BDNF and BHFS LI-rTMS significantly increased CF reinnervation, without additive effect. To identify potential underlying mechanisms, we examined intracellular calcium flux during the 10-min stimulation. Complex high-frequency stimulation increased intracellular calcium by release from intracellular stores. Thus, even at low intensity, rTMS modifies PC structure and induces CF reinnervation.

Transporting neonates with hypoxic-ischemic encephalopathy utilizing active hypothermia

OBJECTIVE

The objective of this report was to evaluate a servo-controlled active hypothermia device used during the transport of neonates with HIE.

STUDY DESIGN

Retrospective review of all cases of therapeutic hypothermia, both passive and active, using a servo-controlled device in a single regional referral neonatal intensive care unit from 2009-2013 RESULTS: An ambulance (43%), fixed wing aircraft (25%), or helicopter (32%) transported 28 neonates with active hypothermia. The servo-controlled device captured core temperatures in all 28 neonates, resulting in 2,985 minutes of data. All neonates attained a core temperature between 33-34 °C by 33 minutes of the transport. Once the neonates attained a core temperature, the average temperature for the remainder of the transport was 33 ± 0.2 °C. The neonates maintained the core temperature regardless of the type of transport vehicle.

CONCLUSION

Servo-controlled hypothermia enables rapid attainment of targeted temperatures and maintains the temperature throughout the transport process in both ground and air transport.

On or off pump coronary bypass? Insight from matched and principal component analyses of 8779 operations

AIM

The aim of this paper was to compare the clinical impact of the different myocardial protection strategies in coronary artery bypass grafting (CABG) patients to facilitate decision-making for use of on- or off-pump technique.

METHODS

Prospectively collected data for primary CABG patients between April 1, 1996 and December 30, 2010 (N.=8779) were analyzed. Early adverse cardiac and cerebrovascular events (ACCE) and late survival were compared between on-pump; cardioplegia (CPA, N.=3862, 44%), cross-clamp fibrillation (XCF, N.=3751, 43%), and off-pump (N.=1166, 13%) myocardial protection. Second, clinical profiling for the risk of ACCE with each strategy was performed using principal component analysis. Finally, a 1:1 matched cohort comparison of 1055 patients was done.

RESULTS

There were vast differences in baseline characteristics between groups. Significantly fewer grafts per patient were constructed using off-pump. There were no remarkable differences in operative mortality and 10-year survival rates between the groups after restrictive matching. Principal component analysis identified high risk profiles; factor 1 (ejection fraction 30-50%, prior myocardial infarction, non-elective operation), and factors 4 (hypertension, hypercholesterolemia, Body Mass Index >30 kg/m2) and 5 (female, octogenarian, left main stem disease) to be strongly associated with ACCE after on-pump CABG while lower risk profiles; factors 5 and 6 (extracardiac arteriopathy, prior stroke) were associated with ACCE after off-pump CABG.

CONCLUSION

Comparatively, on-pump techniques were associated with greater risk of adverse events in "high risk" patients defined by clinical characteristics, while off-pump was associated with increased risk of adverse events in "low risk" patients.

Mesenchymal stem cells regulate cytoskeletal dynamics and promote cancer cell invasion through low dose nitric oxide

Bone marrow-derived mesenchymal stem cells (BMSCs) can be recruited to tumor sites and integrate into the stroma of tumors. When co-cultured with BMSCs, otherwise weakly metastatic nasopharyngeal carcinoma cells (NPC) showed improved metastatic ability. BMSCs in the tumor environment displayed the characteristics of macrophages. Nitric oxide produced by BMSCs in tumor environment could translocate caldesmon to podosome in Ca2+/calmodulin manner and promoted metastatic ability of NPC cells through invadopodia formation, with which the NPC cells degrade the extracellular matrix. Thus, we concluded that the BMSCs promoted cell migration and invasion through nitric oxide-induced paracrine signals.

Predictors of low bone mineral density of the stroke-affected hip among ambulatory individuals with chronic stroke

Risk of hip fracture is greater poststroke than in an age-matched healthy population, in part because of declining hip BMD. We found that individuals may be at risk of loss of hip BMD from muscle atrophy, asymmetrical gait, and poor affected-side ankle dorsiflexor strength. These impairments may be targeted during rehabilitation.

INTRODUCTION

This study aimed to determine predictors of low hip BMD on the stroke-affected side in people living in the community.

METHODS

Forty-three participants (female; 27.9%), mean age 62.4 ± 13.5 and 17.9 ± 32.8 months, poststroke with motor impairments underwent dual energy X-ray absorptiometry scans. Gait characteristics, isometric strength, body composition, and fasting plasma lipids were measured.

RESULTS

At entry, 34.9% (15/43) of the participants had low total hip BMD on the stroke-affected side. Of those with low BMD, 93.3% (14/15) had a step length symmetry ratio >1, indicating greater reliance on the non-paretic leg for weight bearing. Logistic regression analysis revealed that lower affected-side ankle dorsiflexor strength (ß = 0.700, p = 0.02), lower total body fat-free mass index (ß = 0.437, p = 0.02), and greater step length symmetry ratio during walking (ß = 1.135 × 10(3), p = 0.03) were predictors of low hip BMD.

CONCLUSION

Low BMD of the stroke-affected side hip is prevalent in over a third of individuals with lower limb motor impairments. These individuals may be at particular risk of accelerated loss of BMD at the hip from asymmetrical gait pattern and poor affected-side ankle dorsiflexor strength. These impairments are intervention targets that may be addressed during rehabilitation which includes resistance training and addresses gait impairments.

Matrine-induced apoptosis of human nasopharyngeal carcinoma cells via in vitro vascular endothelial growth factor-A/extracellular signal-regulated kinase1/2 pathway inactivation

Matrine, a main active extract from Sophora flavescens Ait, has been demonstrated to exert anticancer effects on various cancer cell lines, such as malignant melanoma, breast cancer, and lung cancer. However, it is currently unclear whether matrine could also elicit an inhibitory effect on growth of nasopharyngeal carcinoma (NPC), let alone the possible molecular mechanisms. Therefore, in a previous study, we investigated matrine-induced proliferation inhibition and apoptosis in NPC cells. It was shown that proliferation of human NPC cells (CNE1 and CNE2) was significantly diminished by matrine in a dose- and time-dependent manner, and apoptosis was induced in both 2 NPC cells, particularly in CNE2 cells. Moreover, the increased apoptosis rate in matrine-treated CNE2 cells confirmed the proapoptotic activity of matrine. We further found that matrine treatment dose- and time-dependently reduced the levels of vascular endothelial growth factor-A (VEGF-A), and inactivated extracellular signal-regulated kinase1/2 (ERK1/2), followed by increased expression of downstream target caspase-3. Overall, we conclude that matrine could induce apoptosis of human NPC cells via VEGF-A/ERK1/2 pathway, which supports the potential use of matrine in clinically treating NPC.