Intrahepatic T helper 17 cells recruited by hepatitis B virus X antigen-activated hepatic stellate cells exacerbate the progression of chronic hepatitis B virus infection

Immunopathological injury induced by persistent hepatitis B virus (HBV) infection contributes to the progression from chronic hepatitis B (CHB) to hepatic cirrhosis and hepatocellular carcinoma (HCC). Regulatory T cells (Tregs), CD4⁺ T helper (Th) cells, and hepatic stellate cells (HSCs) are considered to be the pivotal factors during this progression. In this study, our aim was to investigate the molecular mechanisms of liver immunopathological injury associated with Tregs, CD4⁺ Th cells, and HSCs. Liver tissues were collected to assay the cytokines and distribution and frequencies of CD4⁺ Th cells and Tregs. The chemotaxis of Th17 cells towards the liver and the interactions between IL-22, IL-17A, and HSCs were explored. The data showed the frequencies of Th17 cells, and their effector molecules IL-22 and IL-17A were increased along with the severity of chronic liver diseases. However, the frequencies of Tregs were decreased in HBV-associated cirrhotic tissues compared with those in CHB tissues and HCC tissues. hepatitis B virus X antigen (HBxAg)-activated HSCs recruited more Th17 cells into the liver and conduced to the secretion of IL-17A and IL-22 that could in turn stimulate the proliferation and fibrotic marker secretion of the HSCs. Therefore, we suggest that the interactions between Th17 cells, IL-17A, IL-22, and HSCs form a positive feedback loop that aggravated the progression of chronic liver disease with HBV infection through the phosphoinositide-3-kinase/protein kinase B (PI3K/AKT) signalling pathway. Our findings indicated the IL-17A/IL-22 pathway might become a new treatment target for liver cirrhosis and HCC.

Short- and potential long-term adverse health outcomes of COVID-19: a rapid review

The coronavirus disease 2019 (COVID-19) pandemic has resulted in millions of patients infected worldwide and indirectly affecting even more individuals through disruption of daily living. Long-term adverse outcomes have been reported with similar diseases from other coronaviruses, namely Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). Emerging evidence suggests that COVID-19 adversely affects different systems in the human body. This review summarizes the current evidence on the short-term adverse health outcomes and assesses the risk of potential long-term adverse outcomes of COVID-19. Major adverse outcomes were found to affect different body systems: immune system (including but not limited to Guillain-Barré syndrome and paediatric inflammatory multisystem syndrome), respiratory system (lung fibrosis and pulmonary thromboembolism), cardiovascular system (cardiomyopathy and coagulopathy), neurological system (sensory dysfunction and stroke), as well as cutaneous and gastrointestinal manifestations, impaired hepatic and renal function. Mental health in patients with COVID-19 was also found to be adversely affected. The burden of caring for COVID-19 survivors is likely to be huge. Therefore, it is important for policy makers to develop comprehensive strategies in providing resources and capacity in the healthcare system. Future epidemiological studies are needed to further investigate the long-term impact on COVID-19 survivors.

Mycoplasma pneumoniae lipids license TLR-4 for activation of NLRP3 inflammasome and autophagy to evoke a proinflammatory response

Mycoplasma pneumoniae is an obligate pathogen that causes pneumonia, tracheobronchitis, pharyngitis and asthma in humans. It is well recognized that membrane lipoproteins are immunostimulants exerting as lipopolysaccharides (LPS) and play a crucial role in the pathogenesis of inflammatory responses upon M. pneumoniae infection. Here, we report that the M. pneumoniae-derived lipids are another proinflammatory agents. Using an antibody-neutralizing assay, RNA interference or specific inhibitors, we found that Toll-like receptor 4 (TLR-4) is essential for M. pneumoniae lipid-induced tumour necrosis factor (TNF)-α and interleukin (IL)-1β production. We also demonstrate that NLR family pyrin domain containing 3 inflammasome (NLRP3) inflammasome, autophagy and nuclear factor kappa B (NF-κB)-dependent pathways are critical for the secretion of proinflammatory cytokines, while inhibition of TLR-4 significantly abrogates these events. Further characterization revealed that autophagy-mediated inflammatory responses involved the activation of NF-κB. In addition, the activation of NF-κB promoted lipid-induced autophagosome formation, as revealed by assays using pharmacological inhibitors, 3-methyladenine (3-MA) and Bay 11-7082, or silencing of atg5 and beclin-1. These findings suggest that, unlike the response to lipoprotein stimulation, the inflammation in response to M. pneumoniae lipids is mediated by the TLR-4 pathway, which subsequently initiates the activation of NLRP3 inflammasome and formation of a positive feedback loop between autophagy and NF-κB signalling cascade, ultimately promoting TNF-α and Il-1β production in macrophages.

Continuum constitutive laws to describe acoustic attenuation in glasses

Nowadays metamaterials are at the focus of an intense research as promising for thermal and acoustic engineering. However, the computational cost associated to the large system size required for correctly simulating them imposes the use of finite-elements simulations, developing continuum models, able to grasp the physics at play without entering in the atomistic details. Still, a correct description should be able to reproduce not only the extrinsic scattering sources on waves propagation, as introduced by the metamaterial microstructure, but also the intrinsic wave attenuation of the material itself. This becomes dramatically important when the metamaterial is made out of a glass, which is intrinsically highly dissipative and with a wave attenuation strongly dependent on frequency. Here we propose a continuum mechanical model for a viscoelastic medium, able to bridge atomic and macroscopic scale in amorphous materials and describe phonon attenuation due to atomistic mechanisms, characterized by a defined frequency dependence. This represents a first decisive step for investigating the effect of a complex nano- or microstructure on acoustic attenuation, while including the atomistic contribution as well.

Effects of epidural infusion of morphine combined with small-dose naloxone on gastrointestinal interstitial cells of Cajal in rabbits

OBJECTIVE

To study the effect of epidural infusion of morphine combined with small-dose naloxone on gastrointestinal interstitial cells of Cajal (ICC) in rabbits.

MATERIALS AND METHODS

A total of 80 healthy New Zealand rabbits were selected as objects of study, and divided into normal saline control group (Group NS, n=20), morphine group (Group M, n=20), naloxone group (Group N, n=20), and morphine + naloxone group (Group NM, n=20). Rabbits in four the groups received epidural catheterization for continuous drug infusion for 7 d, and epidural analgesia pump was connected. Visual analogue scale (VAS) score, intestinal propulsion rate, c-kit expression, and ICC count were detected and compared among four groups of rabbits.

RESULTS

No statistical differences of occurrence rates regarding constipation as well as expressions of c-kit and ICC count in the proximal colon were shown among rabbits in Group NS, Group N, and Group NM during drug administration (p>0.05). However, the occurrence rates of constipation of rabbits in Group M at 3-7 d were statistically higher than those in Group NS, Group N, and Group NM, and the differences were statistically significant (p<0.05). Moreover, the VAS scores in Group NS and Group N were significantly higher than those in Group M and Group NM, while the scores in Group M were also significantly increased compared to that in Group NM (p<0.05). The intestinal propulsion rates, expressions of c-kit and ICC counts of rabbits in Group NS, Group N, and Group NM were statistically higher than that in Group M (p<0.05).

CONCLUSIONS

Epidural infusions of morphine combined with small-dose naloxone effectively inhibit the gastrointestinal motility of rabbits via the reduction of ICC in the proximal colon of the gastrointestinal tract of rabbits. Moreover, small-dose of naloxone enhances the analgesic effect and reduces the risk of adverse reactions.

Observation of a neutron spin resonance in the bilayered superconductor CsCa2Fe4As4F2

We report inelastic neutron scattering (INS) investigations on the bilayer Fe-based superconductor CsCa2Fe4As4F2above and below its superconducting transition temperatureTc≈ 28.9 K to investigate the presence of a neutron spin resonance. This compound crystallises in a body-centred tetragonal lattice containing asymmetric double layers of Fe2As2separated by insulating CaF2layers and is known to be highly anisotropic. Our INS study clearly reveals the presence of a neutron spin resonance that exhibits higher intensity at lower momentum transfer (Q) at 5 K compared to 54 K, at an energy of 15 meV. The energyERof the observed spin resonance is broadly consistent with the relationshipER= 4.9kBTc, but is slightly enhanced compared to the values observed in other Fe-based superconductors. We discuss the nature of the electron pairing symmetry by comparing the value ofERwith that deduced from the total superconducting gap value integrated over the Fermi surface.

[Isolated biceps tenodesis by double row for pulley lesions]

Objective: To explore clinical outcome of isolated arthroscopic biceps tenodesis by double row for pulley lesions. Methods: Forty-nine patients with pulley lesions were treated from July 2017 to June 2018 in the Department of Sport Medicine, the Affiliated Zhongshan Hospital of Dalian University by isolated arthroscopic biceps tenodesis by double row. Patients were divided into 2 groups according to the intraoperative damage of the pulley system. In group A, there were 16 patients with isolated superior glenohumeral ligament/coracohumeral ligament (SGHL/CHL) complex lesions, including 9 males and 7 females, aged (55±6) years. In group B, there were 33 patients (15 males and 18 females, aged (57±8) years) with SGHL/CHL complex and adjacent supraspinatus tendon and/or subscapularis tendon articular-side partly tears. Patients in two groups were treated with different isolated arthroscopic biceps tenodesis by double row. Constant-Murley shoulder score and pain visual analogue scale (VAS) score were assessed before operation and 3, 6, 12 months after the operation. Postoperative complications were also recorded in two groups. The t test was used to compare the quantitative data within and between two groups. Results: All 49 patients were followed up for 12 to 24 months with an average of (17±6) months. The first-stage healing was achieved in all incisions in the two groups. No surgical complications related to revision, infection, Popeye syndrome and cramping pain were observed in either group. There was 1 case treated by secondary arthroscopy for retrauma in group B. The Constant-Murley shoulder score in group A before the operation was 46±10, and it was increased to 89±9 at the 12 months post operation(t=-22.637, P<0.05); and it was 39±10 and 87±8 before and 12 months after the operation respectively in group B (t=-44.849, P<0.05). The VAS scores in the two groups were both decreased significantly at the 12 months post operation when compared with those before the operation (0.68±0.70 vs 5.25±0.27 and 0.72±0.83 vs 5.69±0.84, respectively) (t=29.007, 37.079, both P<0.05). Conclusion: Isolated arthroscopic biceps tenodesis by double row can relieve pain, recover functions of shoulder joint effectively, and achieve a satisfactory outcome in the treatment of pulley lesions.

Unmet Dental Care Need and Associated Barriers by Race/Ethnicity among US Adults

INTRODUCTION

Ability to access needed dental care may vary among population subgroups. We assessed 1) the differences in the proportions of adults who reported unmet dental care needs in the past 12 months and the associated barriers (structural, financial, and cognitive) in 2015 to 2016 versus 2003 to 2004 by race/ethnicity and 2) the subgroups that are more likely to report unmet dental care needs.

METHODS

Data of 10,029 respondents aged ≥19 y from the 2003-2004 and 2015-2016 National Health and Nutrition Examination Surveys were used. Chi-square tests assessed the differences in the proportions of adults who reported not getting the needed dental care between the periods. A multiple logistic regression model was run to identify characteristics that were significantly associated with unmet need after adjusting for other factors.

RESULTS

Overall, 19.4% of the adults reported an unmet dental care need in 2015 to 2016, as compared with 21% in 2003 to 2004. The overall unmet dental care need decreased only in the Hispanic groups (34% to 28%, P = 0.045) between 2003-2004 and 2015-2016. Between the periods, unmet need decreased among Hispanics aged 19 to 64 y (35% to 28%, P = 0.02), Hispanics with some college education or above (33.5% to 21.0%, P = 0.008), and nonpoor Hispanic adults (29.8% to 20.4%, P = 0.048). No significant differences were observed in the proportions of adults reporting structural (P = 0.09), financial (P = 0.86), or cognitive (P = 0.07) barriers between the periods. When compared with their counterparts, nonelderly adults, women, Hispanics, adults with a high school education, those with less than a high school education, and poor adults were significantly more likely to report unmet dental care needs.

CONCLUSIONS

Racial and ethnic disparities in accessing and receiving the needed dental care still exist. Financial barriers to dental care are the most commonly cited reasons for not getting the needed dental care.

KNOWLEDGE TRANSFER STATEMENT

The results of the study will inform policy makers, public health planners, and dental professionals about subgroups that still face difficulty in receiving the dental care they need. Policy makers should develop new policies to mitigate the financial barriers that are still prevalent. Dental professionals can mitigate the public's cognitive and financial barriers by educating the community through outreach programs and by providing services to low-income populations at reduced charges or through alternative payment plans.

Neuropsychiatric Symptoms and Risk Factors in Mild Cognitive Impairment: A Cohort Investigation of Elderly Patients

BACKGROUND

Neuropsychiatric symptoms (NPS) have been shown to affect the progression and development of Alzheimer's disease (AD) in the elderly. However, the published data are still controversial and limited in large cohort-based NPS study.

AIM

To explore the potential relationship between NPS and mild cognitive impairment (MCI) among the elderly of Chinese community.

METHODS

A total of 465 Chinese community-dwelling elderly (age ≥ 60 years) with mild cognitive impairment (MCI) were recruited into this investigation. At baseline, enrolled participants were assessed for Clinical Dementia Rating (CDR), mini-psychiatric examination. They were also subjected to categorical language fluency test, list learning and delayed recall. We assessed the NPS severity by Neuropsychological Inventory (NPI). The global cognitive status (GCS) of the participants at the end of the 3-year study period were measured with the CDR.

RESULTS

Approximately 41.6% of subjects had 1 or more NPS (total NPI score ≥ 1) at baseline. The most common NPSs were nocturnal behavior (20.8%), depression (17.3%), apathy (12.7%) and anxiety (13.2%). At the end of 3-year follow-up, 26.9% of baseline depressed patients developed AD, while 15.2% of baseline non-depressed patients developed AD (χ2 = 4.86, P=0. 04). Abnormal motor behavior was significantly correlated with cognitive deterioration as well (χ2 = 5.75, P=0. 03). Logistic regression analysis revealed that depression was considered as a risk factor for AD progression at baseline (95% CI: 1.12-5.67, OR=2.37, P=0.03).

CONCLUSIONS

Depression may be an independent factor representing early neurodegeneration in elder patients with MCI. Further studies are warranted to assess whether effective management of NPS promotes the cognitive functions.

miR-186-5p targeting SIX1 inhibits cisplatin resistance in non-small-cell lung cancer cells (NSCLCs)

miR-186-5p has been reported to be implicated in tumorigenesis and paclitaxel resistance in non-small-cell lung cancer cells (NSCLCs). However, it remains undisclosed whether miR-186-5p takes a part in chemoresistance against diaminodichloroplatinum (cisplatin, DDP) in lung cancers, including NSCLC. Expression of miR-186-5p and sine oculis homeobox 1 (SIX1) was detected using RT-qPCR and western blot. In vitro, 50% inhibitory concentration (IC50) of DDP and cell proliferation were measured by MTT assay. The rate of apoptosis and abilities of migration and invasion were evaluated with flow cytometry and Transwell assay. The target binding between miR-186-5p and SIX1 was predicted on Diana tools software and confirmed by dual-luciferase reporter assay and RNA immunoprecipitation. In vivo experiments, xenogeneic transplantation was conducted to monitor the tumor growth. Expression of miR-186-5p was downregulated in DDP resistant NSCLC tissues and cells (A549/DDP and H1299/DDP). Functionally, miR-186-5p overexpression could inhibit cell proliferation, migration and invasion, and promoted apoptosis rate in A549/DDP and H1299/DDP cells. Mechanically, SIX1 was identified as a downstream target for miR-186-5p and was highly expressed in A549/DDP and H1299/DDP cells. Similarly, SIX1 knockdown could also suppress DDP resistant NSCLC cell proliferation, migration and invasion, and promote apoptosis rate, which was reversed by miR-186-5p downregulation. Moreover, xenograft tumors induced by A549/DDP cells exerted cisplatin resistance, and miR-186-5p overexpression could inhibit tumor growth under DDP treatment. In conclusion, upregulation of miR-186-5p suppresses cisplatin resistance in DDP resistant NSCLC cells both in vitro and in vivo presumably by targeting SIX1.

[Impact of oxidative stress on renal dopamine D(1) receptor dysfunction in offspring of diabetic rat dams]

Objective: To explore the effects of oxidative stress on renal dopamine D(1) receptor dysfunction in offspring of diabetic rat dams. Methods: The pregnant Sprague Dawley (SD) rats (n=10) were randomly divided into the diabetic group (a single intraperitoneal injection of 35 mg/kg streptozotocin on day 0 of gestation) and control group (injected with the equal volume of 0.9% saline on day 0 of gestation) according to the random number table (n=5 each group). The offspring rats were divided into 4 groups including offspring of control dams treated with vehicle, offspring of control dams treated with antioxidant, offspring of diabetic dams treated with vehicle and offspring of diabetic dams treated with antioxidant (n=10 each group). After birth, the offspring rats were treated with normal drinking water or antioxidant (tempol, 1.0 mmol/L) from the age of 4 weeks until the end of the study (20 weeks). The blood pressure was monitored continuously by non-invasive tail-cuff method. The renal oxidative markers including superoxide dismutase (SOD) and malondialdehyde (MDA) activity and D(1) receptor agonist (fenoldopam)-mediated urinary and sodium excretion were detected. Furthermore, the protein expression of renal G protein-coupled receptor kinase 2 (GRK2), GRK4, dopamine D(1) receptor and the phosphorylation level of D(1) receptor were detected. Results: The mean arterial pressure of offspring from the diabetic dams treated with vehicle was significantly higher than that of offspring from control dams treated with vehicle (P=0.013), while the mean arterial pressure of offspring from diabetic dams treated with antioxidant was significantly lower than that of offspring from the diabetic dams treated with vehicle (P=0.038). The fenoldopam-mediated urinary flow and urinary sodium excretion rate were significantly lower in offspring of diabetic dams treated with vehicle than those in offspring of control dams treated with vehicle (P<0.01), which were significantly higher in offspring of diabetic dams treated with antioxidant as compared to offspring of diabetic dams treated with vehicle (both P<0.01). There was no significant difference in fenoldopam-mediated urinary flow and urinary sodium excretion rate in offspring of control dams treated with antioxidant or vehicle (urinary flow: P=0.772; urinary sodium excretion rate: P=0.716). Compared with offspring of control dams treated with vehicle, the renal MDA activity was significantly increased, while the SOD activity was significantly decreased in offspring of diabetic dams treated with vehicle (MDA: P<0.01; SOD: P=0.013). The renal MDA activity was significantly decreased, while the SOD activity was significantly increased in offspring of diabetic dams treated with antioxidant in comparison with offspring of diabetic dams treated with vehicle (MDA: P<0.01; SOD: P=0.035).The renal GRK2 and GRK4 protein expression in offspring of diabetic dams treated with vehicle were significantly higher than those in offspring of control dams treated with vehicle (P<0.01), while the expression levels of renal GRK2 and GRK4 in offspring of diabetic dams treated with antioxidant were significantly downregulated compared with offspring of diabetic dams treated with vehicle (P<0.01). There was no significant difference in the protein expression of dopamine D(1) receptor among 4 groups (P=0.735). The level of dopamine D(1) receptor phosphorylation in offspring of diabetic dams treated with vehicle was significantly higher than that in offspring of control dams treated with vehicle (P<0.01), while the dopamine D(1) receptor phosphorylation level was significantly lower in offspring of diabetic dams treated with antioxidant compared to that in offspring of diabetic dams treated with vehicle (P<0.01). Conclusion: Oxidative stress is involved in the dopamine D(1) receptors dysfunction in the offspring of diabetic dams.

Bone mineral density from early to middle adulthood in persons with Down syndrome

BACKGROUND

While accelerated ageing is recognised among individuals with Down syndrome (DS), the trajectory of their bone health across adulthood remains poorly understood.

METHODS

This study aimed to determine the age-related loss of bone mineral density (BMD) of the lumbar spine in 128 adults with DS aged 18 to 54 years compared with 723 counterparts without DS.

RESULTS

Men and women with DS had lower level of BMD than counterparts without DS across age groups. Magnitude of decrement in BMD as reflected in the z-scores was similar between younger and older men with DS. Older women with DS, on the contrary, showed greater decrement in older ages especially in their fourth decade of life. Osteopenia and osteoporosis as defined using age-specific and gender-specific T-scores affected greater number of men with DS (38% and 25%) than women (17% and 17%) aged 40-49 years.

CONCLUSIONS

Findings supported adults with DS, especially men, to have early bone mineral testing.