Cyclo-(Phe-Tyr) as a novel cyclic dipeptide compound alleviated ischemic stroke reperfusion brain injury via JUNB/JNK/NF-κB and SOX5/PI3K/AKT pathways

Ischemic stroke reperfusion (IR) can cause adverse reactions including apoptosis, oxidative stress, and inflammation, but the existing therapeutic strategies have been limited. Moreover, the regulation of microglia plays an important role in brain injury after reperfusion. Hence, it is imperative to find new and effective drugs for modulating microglia to treat IR brain injury. Cyclic peptide compound cyclo-(Phe-Tyr) (Sparganin C, SC) is a compound isolated from Sparganii Rhizoma. However, the protective effects of SC on the central nervous system are rather unclear. In an attempt to elucidate the protective effects and mechanism of SC on cerebral damage induced by the IR, we used a middle cerebral artery occlusion reperfusion (MCAO/R) model in rats and discovered that SC significantly decreased the size of cerebral infarcts, improved neurological scores, and blocked inflammatory and oxidative factor release. Using RNA-Seq and metabolomics association analyses, SC was shown to have a protective impact through the JUNB and SOX5-related pathways. Metabolomic analysis revealed twenty-eight differentially expressed biomarkers. In addition, the detection of SC content in brain tissue using LC/MS revealed that SC had blood-brain barrier penetration. To investigate the mechanism, we established an in vitro BV2 cell oxygen-glucose deprived re-oxygenation (OGD/R) model and used siRNA as well as an inhibitor. The protective effects of SC were dependent on the JUNB and SOX5 to inhibit inflammation and apoptosis in microglia. Our findings revealed for the first that SC against IR injury by reducing inflammation and apoptosis while simultaneously acting as potential therapeutic lead compound for ischemic stroke.

High efficiency and collimated terahertz pulse from ultra-short intense laser and cone target

We propose a new, to the best of our knowledge, method to radiate a high-efficiency and collimated terahertz (THz) pulse from a relativistic femtosecond laser and cone target. Particle-in-cell simulations demonstrate that a THz source of 40 mJ, pointing at an angle of ∼20 ^∘, can be generated from a laser pulse of 1.9 J by using a cone target whose open angle is 10 ^∘. The peak power of the THz pulse is 10¹¹ W. This method, which manipulates the divergence angle and the energy conversion efficiency of the THz source, should promote THz science into the extra strong region with a compact laser system.

Clinical study of sodium bicarbonated Ringer's solution on fluid resuscitation of patients with hemorrhagic shock

OBJECTIVE

Fluid resuscitation is a crucial step in shock treatment, but the choice of crystal solution remains controversial. Sodium bicarbonated Ringer's solution can not only effectively expand blood volume, but also reduce tissue damage and acidosis. The study aims to evaluate the resuscitation effect of sodium bicarbonated Ringer's solution on patients with hemorrhagic shock.

PATIENTS AND METHODS

A total of 96 patients with hemorrhagic shock were randomly assigned to receive either normal saline solution (control group) or sodium bicarbonated Ringer's solution (experimental group). The changes in blood lactate, heart rate, arterial pH and mean arterial pressure (MAP) were measured at different time points. The 28-day survival rate, the incidence of complications, and the average length of hospital stay were recorded. Simult RESULTS: The heart rate, blood lactate, sodium, and chloride in the experimental group were significantly lower than those in the control group, while the MAP, potential of hydrogen (pH), bicarbonate, and base excess in the experimental group were significantly higher than those in the control group at every observed time point after resuscitation (p<0.05). Compared with the control group, the experimental group had a lower incidence of acute respiratory distress syndrome (ARDS) (8.3% vs. 22.9%, p<0.05), shorter mechanical ventilation time (2.2 vs. 3.5, p<0.05), and shorter intensive care unit length of stay (3.8 vs. 4.1, p<0.05). The 28-day survival rate between the two groups showed no significant differences (p>0.05).

CONCLUSIONS

Early resuscitation with sodium bicarbonated Ringer's solution could better maintain acid-base balance and hemodynamic stability and reduce the risk of related complications.

Integrated Analysis of the Cecal Microbiome and Plasma Metabolomics to Explore NaoMaiTong and Its Potential Role in Changing the Intestinal Flora and Their Metabolites in Ischemic Stroke

Ischemic stroke (IS), as a leading cause of disability worldwide, affects intestinal bacterial communities and their metabolites, while recent discoveries have highlighted the importance of the intestinal microflora in the development of IS. Systematic investigations of complex intestinal bacterial communities and their metabolites during ischemic brain injury contribute to elucidate the promising therapeutic targets for IS. However, the associations between intestinal microbiota and related circulating metabolic processes in IS remained unclear. Hence, to identify the changed microflora and their metabolites in IS of NaoMaiTong (NMT), an effective clinical medication, we established the middle cerebral artery occlusion/reperfusion (MCAO/R) model using conventionalized and pseudo-germ-free (PGF) rats. Subsequently, we systematically screen the microflora and related metabolites changing in IS via an integrated approach of cecal 16S rRNA sequencing combined with plasma metabolomics. We found that NMT relied on intestinal flora to improve stroke outcome in conventionalized rats while the protection of NMT was reduced in PGF rats. Total 35 differential bacterial genera and 26 differential microbial metabolites were regulated by NMT. Furthermore, L-asparagine and indoleacetaldehyde were significantly negatively correlated with Lachnospiraceae_UCG.001 and significantly positively correlated with Lachnoclostridium. Indoleacetaldehyde also presented a negative correlation with Lactobacillus and Bifidobacterium. 2-Hydroxybutyric acid was strongly negatively correlated with Ruminococcus, Lachnospiraceae_UCG.001 and Lachnospiraceae_UCG.006. Creatinine was strongly negatively correlated with Akkermansia. In summary, the research provided insights into the intricate interaction between intestinal microbiota and metabolism of NMT in IS. We identified above differential bacteria and differential endogenous metabolites which could be as prebiotic and probiotic substances that can influence prognosis in stroke and have potential to be used as novel therapeutic targets or exogenous drug supplements.

Cyclo-(Phe-Tyr) reduces cerebral ischemia/reperfusion-induced blood-brain barrier dysfunction through regulation of autophagy

Cerebral ischemia/reperfusion (I/R) injury is the result of ischemic stroke, a serious threat to public health. I/R injury can damage the blood-brain barrier (BBB), adversely affecting the brain environment and...

Development and internal validation of a diagnostic prediction model for COVID-19 at time of admission to hospital

BACKGROUND

Early coronavirus disease 2019 (COVID-19) diagnosis prior to laboratory testing results is crucial for infection control in hospitals. Models exist predicting COVID-19 diagnosis, but significant concerns exist regarding methodology and generalizability.

AIM

To generate the first COVID-19 diagnosis risk score for use at the time of hospital admission using the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) checklist.

DESIGN

A multivariable diagnostic prediction model for COVID-19 using the TRIPOD checklist applied to a large single-centre retrospective observational study of patients with suspected COVID-19.

METHODS

581 individuals were admitted with suspected COVID-19; the majority had laboratory-confirmed COVID-19 (420/581, 72.2%). Retrospective collection was performed of electronic clinical records and pathology data.

RESULTS

The final multivariable model demonstrated AUC 0.8535 (95% confidence interval 0.8121-0.8950). The final model used six clinical variables that are routinely available in most low and high-resource settings. Using a cut-off of 2, the derived risk score has a sensitivity of 78.1% and specificity of 86.8%. At COVID-19 prevalence of 10% the model has a negative predictive value (NPV) of 96.5%.

CONCLUSIONS

Our risk score is intended for diagnosis of COVID-19 in individuals admitted to hospital with suspected COVID-19. The score is the first developed for COVID-19 diagnosis using the TRIPOD checklist. It may be effective as a tool to rule out COVID-19 and function at different pandemic phases of variable COVID-19 prevalence. The simple score could be used by any healthcare worker to support hospital infection control prior to laboratory testing results.

Introduction to DOK2 and its potential role in cancer

Cancer is a complex, multifactorial disease that modern medicine ultimately aims to overcome. Downstream of tyrosine kinase 2 (DOK2) is a well-known tumor suppressor gene, and a member of the downstream protein DOK family of tyrosine kinases. Through a search of original literature indexed in PubMed and other databases, the present review aims to extricate the mechanisms by which DOK2 acts on cancer, thereby identifying more reliable and effective therapeutic targets to promote enhanced methods of cancer prevention and treatment. The review focuses on the role of DOK2 in multiple tumor types in the lungs, intestines, liver, and breast. Additionally, we discuss the potential mechanisms of action of DOK2 and the downstream consequences via the Ras/MPAK/ERK or PI3K/AKT/mTOR signaling pathways.

Oxidation Characteristics of Water Soluble Fractions of Agro-Stalks with Focus on Function of Reactive Inorganics

In order to deepen the understanding of the thermochemical behavior of reactive inorganics, which play an important role in slagging and fouling during combustion of agro-stalks, the oxidation behavior of the water-soluble fraction of corn stover, wheat straw and rice straw was examined using a simultaneous thermogravimetric analyzer. The oxidation characteristics were discussed in combination with elemental analysis of water-soluble fractions. Results showed that reactive inorganics elements account for 30–40% in water-soluble fractions of the three agro-stalks and carbon was oxidized at two separate stages. Four stages were found during oxidation of water-soluble fractions – (1) devolatilisation of organics (100‒400 °C); (2) oxidation of char (400–650 °C); (3) oxidation of char with melting of salts or decomposition of carbonate (650–800 °C); (4) vaporization of KCl (800–1000 °C). This work provides a base study for an optimized design of combustion for agro-stalks and pharmaceutical waste.

Structural characterization, anti-inflammatory and glycosidase inhibitory activities of two new polysaccharides from the root of Pueraria lobata

Diabetes seriously endangers public health and brings a heavy economic burden to the country. Inflammation is one of the main inducing factors of type-2 diabetes (T2D) and may cause some complications of diabetes, such as diabetic encephalopathy and peripheral neuropathy. In-depth research and development of drugs to cure diabetes and complications are of great significance. Pueraria lobate is a medicinal herb used in several countries to treat many diseases. Here, two new polysaccharides (PLB-1-1 and PLB-1-2) were isolated and purified from the root of Pueraria lobata with molecular weights of 9.1 × 10³ Da and 3.8 × 10³ Da, respectively. The structure was evaluated by monosaccharide composition, GC-MS and NMR spectroscopy. It was determined that PLB-1-1 comprised →4)-α-d-Glcp-(1→, α-d-Glcp-(1→, →6)-β-d-Galp-(1→, →3)-α-l-Araf-(1→, →3,6)-β-d-Manp-(1→ and →4,6)-β-d-Manp-(1→, and PLB-1-2 consisted of →4)-α-d-Glcp-(1→, β-d-Glcp-(1→, →4,6)-β-d-Glcp-(1→, →3,6)-β-d-Manp-(1→ and α-l-Fucp-(1→. Furthermore, both PLB-1-1 and PLB-1-2 showed anti-inflammatory and inhibitory activities of α-glucosidase and α-amylase in vitro. Therefore, the new polysaccharides, i.e., PLB-1-1 and PLB-1-2, may be considered candidates for the treatment of diabetes and its related complications.

Through the extraction, isolation and purification of Pueraria lobata, we identified two new polysaccharides with molecular weights of 9.1 × 10³ Da and 3.8 × 10³ Da, and found that they have excellent anti-inflammatory and glycosidase inhibitory effects.

[Research Progress on the Effect of Synthetic Cathinones on Animal Behavior]

Abstract

Synthetic cathinones are a class of new psychoactive substances with a structure similar to amphetamine drugs, which can produce excitatory effects similar to drugs such as amphetamine and cocaine after being taken. In recent years, the abuse of synthetic cathinones worldwide has become increasingly serious, posing a serious threat to social security and public health. This article focuses on several common synthetic cathinones, collects their research results in animal autonomous activity experiments and drug dependence model experiments and summarizes their relevant experimental conclusions in animal body temperature regulation, learning and memory, and anxiety, in order to provide data reference and method guidance for the domestic development of related drug research.

Identification of BRAF p. V600E-Mutant and Wild-Type by MR Imaging in Pleomorphic Xanthoastrocytoma and Anaplastic Pleomorphic Xanthoastrocytoma

BACKGROUND AND PURPOSE

Compared with BRAF p. V600E wild-type pleomorphic xanthoastrocytoma, BRAF p. V600E-mutant pleomorphic xanthoastrocytoma showed a higher survival rate. In this study, we focused on finding preoperative MR imaging differences between BRAF p. V600E mutant and wild-type in pleomorphic xanthoastrocytoma and anaplastic pleomorphic xanthoastrocytoma.

MATERIALS AND METHODS

Twenty-three patients with pathologically confirmed pleomorphic xanthoastrocytoma or anaplastic pleomorphic xanthoastrocytoma in our hospital were retrospectively analyzed from January 2015 to December 2020. They were divided into a BRAF p. V600E-mutant group (including 6 pleomorphic xanthoastrocytomas and 5 anaplastic pleomorphic xanthoastrocytomas) and a wild-type group (including 8 pleomorphic xanthoastrocytomas and 4 anaplastic pleomorphic xanthoastrocytomas). The preoperative MR imaging characteristics of these groups were statistically compared.

RESULTS

The wild-type pleomorphic xanthoastrocytoma group presented with more aggressive conventional and advanced MR imaging features than the mutant pleomorphic xanthoastrocytoma group, including greater mean maximum tumor diameter (3.1 [SD, 0.9] cm versus 1.7 [SD, 0.4 ] cm, P < .05), more frequent heterogeneous contrast enhancement of solid portions (100% versus 0%, P < .001), more obvious peritumoral edema (mean, [2.1 SD, 0.7] cm versus 0.6 [SD, 0.2] cm, P < .01), and lower mean minimum relative ADC (896 [SD, 86] versus 988 [SD, 73], P < .05) and mean relative ADC (1060 [SD, 159] versus 1248 [SD, 116], P < .05) on DWI. However, there was no significant difference in either conventional or advanced MR imaging features between the wild-type anaplastic pleomorphic xanthoastrocytoma group and the mutant anaplastic pleomorphic xanthoastrocytoma group.

CONCLUSIONS

Neurosurgeons should carefully interpret MR images before an operation and select appropriate surgical strategies according to genotype prediction.

[Analysis of prescription and rationality of anti-hypertensive medication among community health centers in Beijing]

Objective: Explore the usage of anti-hypertension drugs and the rationality of hypertension prescription among the primary health centers in Dongcheng District, Beijing. Method: This cross-sectional and retrospective study was applied to analyze the hypertension prescriptions from the 8 community health centers in Dongcheng District. The anatomical, therapeutic and chemical classification (ATC) codes were used to determine the drug category. ATC information was used to filter data containing antihypertensive drugs, and group the number and proportion of ATC categories. The type of drug was judged by its generic name. According to the diagnosis information in the prescription, the prescription containing the Western medicine diagnosis of hypertension was screened out. The comorbidities of hypertension in the study included 7 types of diseases including diabetes, chronic kidney disease, coronary heart disease, heart failure, atrial fibrillation, stroke, and dyslipidemia. The analysis of prescription rationality included rationality of combination medication, rationality of drug dosage and rationality of drug price. The agreed daily dose (DDD) method was used to analyze the rationality of drug dosage. The drug utilization index (DUI) was used as a quantitative indicator to estimate the rationality of medication, and overdose was expressed by DUI>1. The reasonableness of the drug price was judged based on the price of the drug and whether it was a drug in the "4+7" plan. Results: A total of 658 140 prescriptions were extracted as the final data set, involving 7 categories and 60 commonly used anti-hypertensive drugs, and the corresponding cost of medication was ￥96.58 million. Drugs were prescribed according to comorbidities, and the choice followed the international guidelines. Calcium channel blockers (CCB) were the most prescribed drugs in the prescriptions of patients with comorbidities, and α-adrenergic receptor antagonists were the least prescribed drugs. The proportion of diuretics prescribed in hypertensive patients complicating with heart failure was 21.17% (505/2 385), which was much higher than that of patients complicating with other comorbidities (P<0.05). The proportion of diuretics prescribed in hypertension patients complicating with dyslipidemia was lower than that of patients with other comorbidities (2 639 (0.94%), P<0.05), and β-blockers (BB) or angiotensin Ⅱreceptor blockers (ARB) were more likely to be selected (BB: 59 348 (21.08%), ARB: 51 356 (18.24%))in these patients. The proportion of BB in prescriptions for hypertension patients with chronic kidney disease was lower than that of patients with other comorbidities (P<0.05). The proportion of BB in prescriptions for hypertension patients with coronary heart disease was higher than that of other comorbidities (P<0.05). Hypertension patients with atrial fibrillation or stroke accounted for a higher proportion of CCB prescriptions (P<0.05). Single antihypertensive drug prescriptions accounted for the highest proportion, 61.19% (402 745/658 140). Two-combination prescriptions accounted for the highest proportion of combination prescriptions, 72.19% (184 392/255 395). CCB based two-combination prescriptions accounted for the highest proportion, 122 350(66.36%). ARB-based tri-combination prescriptions accounted for the highest proportion, 48 915(89.50%),followed by CCB based tri-combination prescriptions (44 732(81.85%)).There were 2 174 (0.33%) prescriptions with unreasonable combination therapies and DUI>1 were found in 48 out of 60 commonly used drugs. In all possible antihypertensive drugs, only 40.92% (109 227/266 993)followed the "4+7" plan. Conclusions: The anti-hypertensive agents from these prescriptions in the primary health centers are diverse, and the choice is generally complied with the guidelines, but some unreasonable situations existed, especially on the combined anti-hypertensive medication, overdose, and"4+7"plan is not followed completely.

Suboptimal blood pressure control and associated risk for cardiovascular mortality among stroke survivors in China

Background

Elevated blood pressure (BP) is associated with substantial morbidity and mortality in stroke survivors. China has approximately 7.5 million stroke survivors, and accounts for one third of stroke mortality worldwide, but little is known about the prevalence and management of elevated BP as well as its effect on cardiovascular death at the national level.

Purpose

We aim to describe the prevalence and treatment of elevated BP and assess the cardiovascular mortality attributable to elevated BP among stroke survivors in China.

Methods

Based on 3 million participants aged 35–75 years from all 31 provinces in mainland China recruited from September 2014 through August 2019, we assessed the prevalence and treatment of elevated BP (systolic BP ≥140mmHg or diastolic BP ≥90mmHg) among those with self-reported stroke. Cardiovascular death was recorded before December 31st 2019. The age- and sex- specific population attributable fractions of cardiovascular death from elevated BP were estimated based on hazard ratios derived by Cox regression analysis.

Results

Among 91,628 stroke survivors, the mean (SD) age was 62 (8) years, 49% were male sex. The median (IQR) stroke duration was 4 (2,7) years. 61.3% of the individuals had elevated BP, and the prevalence increased with age (from 47.6% at 35–44 years of age to 64.7% at 65–75 years of age) and was slightly higher in rural area (63.2%) than urban area (58.8%). 32.7% of the overall population were treated, and 23.4% of those with elevated BP were treated. Among stroke survivors, elevated BP accounted for 26% of cardiovascular death at 35–75 years of age, and about one third at 35–54 years of age. The age- and sex- specific results were shown in the Table.

Conclusions

In this nationwide cohort of stroke survivors from China, over 60% had elevated BP, and about one third were treated. Elevated BP was associated with particularly substantial cardiovascular mortality for young and middle-aged stroke survivors. National strategies targeting elevated BP are required to improve the prognosis of stroke survivors in China.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Key Research and Development Program from the Ministry of Science and Technology of China Age- and sex-specific HRs and PAFs

Aloe-emodin prevents nerve injury and neuroinflammation caused by ischemic stroke via the PI3K/AKT/mTOR and NF-κB pathway

Ischemic stroke (IS) caused by cerebral arterial occlusion is the leading cause of global morbidity and mortality. Cellular oxidative stress and inflammation play a vital role in the pathological process of neural damage in IS. It is necessary to develop functional food or drugs, which target neuroinflammation and oxidation mechanisms against IS. The molecule compound aloe-emodin (AE) is derived from aloe and rhubarb. However, the exact mechanism of the pharmacological action of AE on IS remains unclear. Here, for aiming to demonstrate the mechanism of AE, our study explored the middle cerebral occlusion reperfusion (MCAO/R) rats in vivo, oxygen and glucose deprivation reperfusion (OGD/R), and lipopolysaccharide (LPS)-stimulated cells in vitro. We found that AE significantly improved the infarct size and behavioral score of MCAO/R rats, decreased the expression of TNF-α, MDA, LDH, Caspase 3, and increased the expression of SOD, Bcl-2/Bax. Liquid chromatography-mass spectrometry (LC/MS) results showed that AE could penetrate the blood-brain barrier in the sham group and MCAO/R group. In vitro, AE significantly protected SH-SY5Y cells from the insult of OGD/R and reduced the production of inflammatory cytokines in BV2 cells stimulated by LPS. In vivo and in vitro, western blot analysis results showed that AE significantly increased the expression of PI3K, AKT and mTOR proteins. In addition, AE significantly decreased NF-κB protein expression in BV2 cells. The use of AKT-specific inhibitor MK-2206 2HCL to inhibit AKT expression can block the protective effect of AE on SH-SY5Y cells subjected to OGD/R insults. Overall, our study suggests that AE protected against cerebral ischemia-reperfusion injury probably via the PI3K/AKT/mTOR and NF-κB signaling pathways. Thus, these results indicated that AE could be a promising first-line therapy for preventing and treating ischemic stroke and can be used as functional food.

Using Proanthocyanidin as a Root Dentin Conditioner for GIC Restorations

Glass ionomer cements (GICs) are considered the material of choice for restoration of root carious lesions (RCLs). When bonding to demineralized dentin, the collapse of dentinal collagen during restorative treatment may pose challenges. Considering its acidic nature and collagen biomodification effects, proanthocyanidin (PAC) could be potentially used as a dentin conditioner to remove the smear layer while simultaneously acting to biomodify the dentinal collagen involved in the bonding interface. In this study, 6.5% w/v PAC was used as a conditioner for sound (SD) and laboratory demineralized (DD) root dentin before bonding to resin-modified GIC (FII), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-modified GIC (FVII), or a high-viscosity GIC (FIX). Root dentin conditioned with deionized distilled water (DDW) or polyacrylic acid (PAA) served as controls. Results indicated FII showed higher shear bond strength (SBS) on SD than the other 2 GICs, especially in PAA-conditioned samples; FIX showed significantly higher SBS than FII and FVII on PAA- or PAC-conditioned DD. In each category of GIC, PAA and PAC did not have a significant influence on SBS in most cases compared to DDW except for a significant decrease in PAC-conditioned SD bonded to FII and a significant increase in PAA-conditioned DD bonded to FIX. The bonding interface between GIC and SD was generally more resistant to the acid-base challenge than DD. Although the alterations in failure modes indicated a compromised interfacial interaction between GICs and PAC-treated root dentin, biomodification effects of PAC on dentin were observed from Raman microspectroscopy analysis in terms of the changes in mineral-to-matrix ratio and hydroxyproline-to-proline ratio of dentin adjacent to the bonding interface, especially of DD. Results from this study also indicated the possibility of using in situ characterization such as Raman microspectroscopy as a complementary approach to SBS test to investigate the integrity of the bonding interface.