[Acute effect of daily mean temperature on ischemic heart disease mortality: a multivariable meta-analysis from 12 counties across Hubei Province, China]

Objective: To evaluate the acute effects of daily mean temperature on ischemic heart disease (IHD) mortality in 12 counties across Hubei Province, China. Methods: We obtained the daily IHD mortality data and meteorological data of the 12 counties for 2009-2012. The distributed lag nonlinear model (DLNM) was used to estimate the community-specific association between mean temperature and IHD mortality. A multivariate meta-analysis was then applied to pool the community-specific relationship between temperature and IHD mortality, and the effects of cold and heat on mortality risk. Results: In 2009-2012, of the 6 702 012 people included in this study, 19 688 died of IHD. A daily average of 1.2 IHD deaths occurred in each community. The annual average mean temperature was 16.6 ℃ during the study period. A nonlinear temperature-IHD mortality relationship was observed for different cumulative lag days at the provincial level. The pooled heat effect was acute but attenuated within 2 days. In contrast, the cold effect was delayed and persisted for more than 2 weeks. Compared with a reference temperature (25^th percentile of mean temperature during the study period, P₂₅), the cold effect for P₁₀ of mean temperature was associated with IHD mortality, the RR(95% CI) was 1.084 (1.008-1.167) at lag 0-14, and 1.149 (1.053-1.253) at lag 0-21. For the P₁ cold temperature, the mortality RR (95% CI) values were 1.116 (0.975-1.276) and 1.220 (1.04-1.428), respectively. We found no significant association between high temperatures and IHD mortality in the present study at different lag days. Conclusion: In Hubei Province, low temperature was associated with increased IHD mortality risk, and cold effects lasted for several days; no significant effect of high temperature was observed.

[Analysis of the results of patch test in 192 patients with hand eczema]

Objective: To investigate the common allergens in the patients with hand eczema. Methods: From November 2014 to March 2016, the patients with hand eczema were tested by the patch test kit of daily life series. Results: The results of the patch test of 192 patients with hand eczema were collected. Allergens were detected in 178 (92.71%) cases. The top 5 allergens were nickel chloride (23.96%) , cobalt chloride (18.75%) , aromatic compounds (17.19%) , nickel sulfate (16.67%) and thimerosal (13.54%). The positive rates of kappa mixture, aromatic compounds, tertiary butyl phenolic resin in males were 16.88% , 14.29% , 11.69% , respectively, which were higher than those (5.22% , 4.35% , 3.48%) in females. Conclusion: Nickel chloride, cobalt chloride, aromatic compounds, nickel sulfate and thimerosal are common allergens in patients with hand eczema.

[Effect of CD40 siRNA on inflammatory response of MRL/Lpr mice]

OBJECTIVE

To observe the effect of CD40 siRNA on expression of IFN-γ, IL-17, IL-4 and anti-dsDNA antibody of systemic lupus erythematosus (SLE) animal model MRL/Lpr mice and to discuss its therapy on MRL/Lpr mice.

METHODS

In the study, 16 female MRL/Lpr mice were randomly divided into control group (n=4), empty vector group (n=4), CD40-siRNA1 group (n=4) and CD40-siRNA2 group (n=4). The vectors expressing siRNA against CD40 were injected by tail veil into MRL/Lpr mice, while MRL/Lpr mice in control group and empty vector group were injected with the same dose of PBS and pGFP-V-RS vector respectively. The injection was given six times and every one day. The mice were sacrificed 14 d after injection, and the spleen tissue was weighed. The pGFP-V-RS was labeled by green fluorescent protein (GFP) and the tissue sections were observed whether siRNA expressed in the spleen. The expression levels of IFN-γ, IL-17, IL-4 and anti-dsDNA antibody in the sera were detected by ELISA method on the 1st day before the first time and the 2nd, 5th, 8th, 11th, and 14th days after last injection, and the expression levels of CD40 mRNA in spleen tissue of MRL/Lpr mice were detected by RT-PCR and the expression levels of CD40 protein in spleen tissue of MRL/Lpr mice were detected by immunohistochemistry method.

RESULTS

The expression vector of CD40-siRNA could express in the spleen of MRL/Lpr. The spleens in CD40-siRNA1 group [(78.85±5.61) mg] and CD40-siRNA2 group [(80.25±4.07) mg] were lower than those in control [(141.88±7.81) mg] and empty vector group [(153.10±7.60) mg]. The levels of IL-17, IFN-γ and anti-dsDNA antibody were lower and the levels of IL-4 was higher in CD40-siRNA1 group and CD40-siRNA2 group on the 2nd, 5th and 8th days after last injection than on the 1st day before the first time (P<0.05). The levels of IFN-γ in CD40-siRNA1 group were (118.74±10.32) ng/L, (115.24±8.26) ng/L and (113.71±5.02) ng/L in turn, the levels of IFN-γ in CD40-siRNA2 group were (117.83±6.83) ng/L, (114.07±0.97) ng/L and (112.67±9.66) ng/L in turn. The levels of IL-17 in CD40-siRNA1 group were (7.05±0.41) ng/L, (6.34±0.76) ng/L and (5.83±0.43) ng/L in turn, the levels of IL-17 in CD40-siRNA2 group were (7.07±0.22) ng/L, (6.35±0.49) ng/L and (6.12±0.80) ng/L in turn. The levels of anti-dsDNA antibody in CD40-siRNA1 group were (7.51±0.29) ng/L, (6.74±0.45) ng/L and (6.32±0.39) ng/L in turn, the levels of anti-dsDNA antibody in CD40-siRNA2 group were (8.19±0.38) ng/L, (7.14±0.50) ng/L and (6.48±0.29) ng/L in turn. The levels of IL-4 in CD40-siRNA1 group were (26.51±1.81)ng/L (27.80±1.72) ng/L and (28.08±2.21) ng/L in turn, the level of IL-4 in CD40-siRNA2 group were (26.28±2.03) ng/L, (28.15±2.95) ng/L and (28.37±1.71) ng/L in turn. The expression levels of IL-17 and IFN-γ antibody increased gradually and the levels of IL-4 decreased gradually in CD40-siRNA1 group and CD40-siRNA2 group on the 11th and 14th days after last injection, then reached to the levels of control group and empty vector group (P>0.05). Though the levels of anti-dsDNA antibody in CD40-siRNA1 group and CD40-siRNA2 group on the 11th day was higher than on the 8th day, there was more significance than those in control group and empty vector group (P<0.05). There was no significance between the 4 groups on the 14th day. The levels of CD40 mRNA and protein were lower in CD40-siRNA1 group and CD40-siRNA2 group than in control group and empty vector group on the 14th day after last injection (P<0.05).

CONCLUSION

CD40-siRNA can reduce the concentration of IL-17, IFN-γ and of anti-dsDNA antibody in serum, and at the same time, it can elevate the concentration of IL-4 and suppress CD40 mRNA and protein of spleen in MRL/Lpr. Meanwhile after suppressing CD40 mRNA and protein, it can reduce inflammatory response of the mice and the disease activity of MRL/Lpr, suggesting that CD40-siRNA has therapy effect on SLE.

[Topical voriconazole as an effective treatment for fungal keratitis]

OBJECTIVE

To evaluate the efficacy of topical voriconazole in patients with fungal keratitis caused by different fungal species.

METHODS

Interventional case series. Eighty-four patients aged 18 years or older from central China with confirmed fungal keratitis who presented at the outpatient department of Henan Eye Institute were enrolled in the study. The patients underwent in vivo confocal scanning laser microscopy examination, coneal scraping and microscopic examination and fungal culture, and then received topical voriconazole, closed curative effects were conducted. The sensitivity of three different diagnostic techniques, spectrum of the fungi, cure rate for fungal corneal infection related to each species were analyzed.

RESULTS

In our study, 84 patients were diagnosed with fungal keratitis based on clinical symptoms, and results of at least one of the examinations of in vivo confocal scanning laser microscopy, conventional smear, and corneal scraping culture and the sensitivity were 92.85%(78/84), 85.71%(72/84), 84.52%(71/84)respectively. In viro confocal scanning laser microscopy. Successful management was achieved in 83.33% of the patients. Topical voriconazole treatment failed in 14 patients(16.67%), who required surgical treatment. In 36 patients with Fusarium corneal infections, 26(72.22%)were successfully treated with topical voriconazole; however, in 18 patients with Aspergillus corneal infections and 7 patients with Alternaria corneal infections, 94.44% and 100.00% of them were successfully treated, respectively. In a case-based dynamic tracking study, in vivo confocal microscopy provided real-time dynamic detection of surviving hyphae. The existence of hyphae was(38.35±17.32)days for Fusarium,(25.00±16.11)days for Aspergillus,(21.00±4.36)days for Alternaria, and(41.50±31.68)days for the focus in the deep stroma. The duration of treatment was similar for all four groups.

CONCLUSIONS

Topical application of voriconazole is on effective method for the freatment of fungal keratitis Topical voriconazole is highly effective for fungal keratitis caused by Alternaria spp. and Aspergillus, however, for Fusarium, it is relatively low effective. (Chin J Ophthalmol, 2016, 52: 657-662).

[Value of prostate volume, PSAD and F/T in the detection of prostate cancer in males with PSA 4-10 μg/L]

OBJECTIVE

To evaluate the association of prostate volume, PSAD and F/T with prostate cancer detection rate in males with a total PSA of 4-10 μg/L.

METHODS

Clinical data of 196 patients who underwent prostate biopsy from November 2006 to September 2010 and with a PSA of 4-10 μg/L were retrospectively analyzed. The association of detection rate of prostate cancer with prostate volume, prostate specific antigen density PSAD) and free PSA/total PSA ratio (F/T) was analyzed by Spearman coefficient, receiver operating characteristic curve and logistic regression analysis.

RESULTS

The prostate volume, PSAD and F/T had a significant association with detection rate of prostate cancer (P<0.05 for all). The odd ratio was 0.96, 1.91 and 0.02, respectively. The area under curve (AUR) was 0.31, 0.66 and 0.63, respectively. The cancer detection rate was decreased along with the increase of prostate volume. When PSAD 0.15 ng·ml(-1)·ml(-1) was used as the cut-off value, the sensitivity, specificity, positive prediction rate and negative prediction rate was 72.3%, 51.1%, 42.3% and 21.2%, respectively. When the patients were divided by prostate volume into <19.9, 20-39.9, 40-59.9, 60-79.9 and >80 ml subgroups, the cancer detection rate of each subgroup was 50.0%, 45.6%, 30.8%, 15.4% and 5.6%, respectively.

CONCLUSION

In patients with a total PSA of 4-10 μg/L, the prostate cancer detection rate has a significant association with prostate volume, PSAD and F/T.

[Acute impact of cold spells on mortality during 2001-2011 in Jiang'an district of Wuhan, China]

OBJECTIVE

To evaluate the association between cold spells and nonaccidental mortality from 2001 to 2011 in the Jiang'an District of Wuhan, China.

METHODS

We collected mortality data for December 2001 to 2010 and January to March 2002 to 2011 in the study area. According to the International Classification of Diseases, we stratified the mortality data into three cause-specific categories: nonaccidental mortality, cardiovascular mortality, and respiratory mortality. We also obtained meteorological data (from the China Meteorological Administration) and ambient pollution data (from the Wuhan Environmental Monitoring Center) during the same periods. In the present study, a cold spell was defined as 5 or more consecutive days with daily average temperatures below the 5th percentile of daily mean temperatures (2.58 ℃) from January to December in 2001-2011. A distributed lag nonlinear model (DLNM) was applied to assess the acute effect of cold spells on daily nonaccidental mortality.

RESULTS

During the study period, the total number of nonaccidental deaths was 17 119, including 9 403 (75.5%) among individuals aged over 65 years; 7 968 (46.5%) people died of cardiovascular disease. According to this definition, there were a total of 13 cold spell events and 111 days of duration in Wuhan during the study period. Study days were divided into three periods: non-cold spell days, 2008 cold spell days, and cold spell days in other years. Average daily mean temperatures of the above three periods were (8.2±4.5), (-0.7±1.4), and (0.8±1.2) ℃, respectively, corresponding to average daily deaths of 14.0±4.2, 18.2±4.5, and 14.9±4.9 for nonaccidental mortality. After adjusting for long-term trends, seasonal trends, weekdays, holidays, and relative humidity, analysis by the DLNM revealed that cold spells were associated with increased mortality risk, with a cumulative relative risk (RR) of 1.56 (95% CI: 1.36-1.79) at lag 0-27 days in 2008, higher than that in other years with 1.23 (95%CI: 1.08-1.41). Cold spells were not significantly associated with respiratory mortality and people under 65 years of age; however, during the 2008 cold spell RR increased to 1.96 (95% CI: 1.62-2.37) and 1.67 (95% CI: 1.43-1.95) for cardiovascular mortality and older adults (≥65 years old), respectively; both males and females had high mortality risk, with RRs of 1.60 (95%CI:1.33-1.92) and 1.50 (95% CI: 1.23-1.84), respectively. The association between cold spells and mortality remained nearly unchanged with and without adjustment for ambient pollutants (PM10, SO2, and NO2) in the DLNMs.

CONCLUSION

In Wuhan, both the 2008 cold spell and cold spells in other years were significantly associated with increased nonaccidental mortality. People with cardiovascular disease and elderly adults may be more susceptible to the impact of cold spells on mortality.

[Retrospective cohort study for the impact on readmission of patients with ischemic stroke after treatment of aspirin plus clopidogrel or aspirin mono-therapy]

OBJECTIVE

To see the influence of different antiplatelet therapies on stroke patients' readmission by performing a deep data-mining into Beijing Healthcare Insuring Database, based on a large sample size.

METHODS

Aretrospective cohort study, was adopted to extract patients primarily diagnosed as ischemic stroke from healthcare database. The first hospital records were considered as the patient's baseline in this study, who were divided into MAPT (aspirin) and DAPT (aspirin and clopidogrel) according to the patient's baseline medications. A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication. The major result events, included: (1) recurrence of ischemic stroke; (2) hemorrhagic transformation of ischemic stroke; (3) myocardial infarction; (4) the digestive hemorrhage. The Kaplan-Meier figure was used to compare the survival situations between these two groups, the log-rank test was used to test the difference of the survival curve, and 1:1 propensity score matching was calculated from the patients' baseline data. Cox proportional hazards model was used to calculate the hazard ratio (HR).

RESULTS

A total of 27 695 patients From January 2010 to September 2013 were included, 4 047 with DAPT, and 23 648 with MAPT. Because the baseline characteristics of the patients was disequilibrium, so we used 1:1 propensity score matching, after which, the number of the two groups was 4 046 each. Adjusted for the general demographic characteristics such as age, sex, nationality, complication and drug combination, no statistical significance was observed between the survival curves of the two groups (P=0.06). HR value of major result events between the groups was 0.91 (0.82-1.01, P=0.07), which was not statistically significant. The covariate gender HR=1.36 (1.20-1.55, P<0.05), accompanied by diabetes HR= 1.36 (1.20-1.54, P<0.05), dyslipidemia HR=1.13 (1.00-1.27, P=1.13), heart disease HR=1.39 (1.22-1.58, P<0.05) was statistically significant. Drug combination with other antiplatelet agents HR=1.05 (0.95-1.17, P>1.05) did not increase the risk of readmission.

CONCLUSION

There was no difference in prevention of readmission between patients with DAPT and MAPT. Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

[Management of 99 intracranial aneurysms in neurovascular hybrid operating room]

OBJECTIVE

To analyze the current status of intracranial aneurysms treated in neurovascular hybrid operating room.

METHODS

In the neurovascular hybrid operating room of New Era Stroke Care & Research Center, the Second Artillery General Hospital PLA, from October 2013 to November 2015, 99 cases of intracranial aneurysms were managed by interventional treatment, open surgery, hybrid surgery or switched surgical procedures.

RESULTS

Patients with intracranial aneurysms treated in neurovascular hybrid operating room achieved good clinical outcome.

CONCLUSION

It is an ideal option to treat intracranial aneurysms in neurovascular hybrid operating room.

Activation and dynamic expression of Notch signalling in dental pulp cells after injury in vitro and in vivo

AIM

To investigate the expression pattern of Notch signalling in odontoblast-like cells stimulated by lipopolysaccharide (LPS) in vitro, and in injured rat dental pulp in vivo.

METHODOLOGY

Mouse odontoblast-like cells (MDPC-23) were exposed to LPS. Expression of Notch-related genes was detected by real-time PCR. A rat pulpitis model was established by mechanical injury and LPS plus mechanical injury was followed by the analysis of expression of Notch2 by immunohistochemical staining. One-way analysis of variance (anova) was performed to examine the effect of differing concentrations of LPS on cell proliferation, and least significant difference test was used for paired comparisons. For independent sample, t-test was performed to compare the expression of Notch signalling genes between LPS group and control group in vitro.

RESULTS

The in vitro study revealed the proliferation of MDPC-23 cells on exposure to 10 ng mL^-1 to 1 μg mL^-1 LPS. Expression of Notch1 and Notch2 was significantly higher in the LPS group than that in the control group on day 1 and day 3 (P ˂ 0.05). The levels of both Delta1 and Jagged1 were higher in the study group than in the control group on day 3 (P = 0.019 and P = 0.034) and day 5 (P ˂ 0.001 and P = 0.046), respectively. In addition, Hes1 levels were significantly higher in the study group than in the control group on day 5 (P = 0.005). The in vivo study demonstrated positive staining for Notch2, both in the mechanical injury (MI) group and in the LPS plus mechanical injury (LMI) group from day 3 to day 7, which showed very weak or absent staining on day 14, thereby demonstrating the dynamic nature of the change.

CONCLUSIONS

Both in vitro and in vivo activation and dynamic expression of Notch signalling in dental pulp cells after injury were found. Notch signalling activation by LPS stimulation or mechanical injury showed a similar pattern in vivo.

Expression and prognostic influence of NF-κB and EGFR in esophageal cancer

The goal of this study was to investigate the expression profiles of nuclear factor-kappa B (NF-κB) and epidermal growth factor receptor (EGFR) in esophageal cancer and to determine their association with tumor prognosis. This study included 40 esophageal cancer patients [22 men and 18 women; average age = 62.7 ± 3.9 years; tumor-node-metastasis (TNM) staging: 12 patients with stage I, 13 patients with stage II, and 15 patients with stage III disease]. Tumor tissues and tumor-adjacent tissue specimens were collected during radical resections at our hospital. Immunohistochemical staining was used to examine these tissues for NF-κB and EGFR expression. Follow-up of all patients included gathering information such as the 3-year survival rate. We found that NF-κB and EGFR expression was significantly higher in tumor tissues compared to tumor-adjacent normal tissues. Expression was not related to gender or age, but was positively associated with the degree of tumor infiltration. NF-κB and EGFR expression levels gradually increased with higher TNM stage, but this difference was not significant. Follow-up results showed that patients with higher NF-κB and EGFR levels had a lower survival rate and unfavorable prognosis. In conclusion, we found that NF-κB and EGFR expression was significantly elevated during the occurrence and development of esophageal carcinoma, and expression of these factors appears to be correlated with cancer progression. Higher expression of both genes is associated with an unfavorable prognosis.

Effect of steam-flaked corn and soybeans on muscle and intramuscular fatty acid composition in Holstein calves

This study aimed to evaluate the effects of steam-flaked corn grains and soybeans on muscle fatty acid composition. Thirty Holstein bull calves (21 ± 3 d) were divided into 3 groups according to birth date and BW and were randomly assigned to receive fresh milk and a commercial pelleted starter diet containing extruded corn and soybean (ECS), steam-flaked corn and soybean (SFCS), or ground corn and raw soybean (GCS). The calves were fed the designated diet from 3 to 13 wk of age, after which they were slaughtered. The supraspinatus (CTM), longissimus lumborum (RLM), and spinalis dorsi (ERM) were analyzed to determine the chemical and intramuscular fatty acid composition. The fatty acid composition of muscle and its deposition differed among calves fed different starter feeds. Medium-chain fatty acid levels of the RLM and CTM were greater in GCS-fed calves than in ECS- and SFCS-fed calves ( < 0.05). Extruded processing increased the content of linoleic, linolenic, and arachidonic acids of the RLM ( < 0.05). The palmitoleic and -vaccenic acid content of the ERM were greater in GCS-fed calves than in ECS- or SFCS-fed calves ( < 0.05). No significant differences were observed among the 3 diets with respect to the stearic, oleic, linoleic, -9 -11 CLA, or arachidonic acid content of the ERM ( > 0.05). The levels of -3 and -6 fatty acids were similar among the 3 groups; a lower -6:-3 PUFA ratio was observed in GCS-fed calves ( < 0.05). The cereal processing method of the calf starter feed had no significant effect on the chemical composition of the CTM, RLM, or ERM. Therefore, different methods of processing corn and soybean in calf starter feeds had no effect on the chemical composition of the RLM, CTM, or ERM but had a significant effect on the intramuscular fatty acid composition.

Is endoscopic sphincterotomy plus large-balloon dilation a better option than endoscopic large-balloon dilation alone in removal of large bile duct stones? A retrospective comparison study

BACKGROUND

Several comparison studies have demonstrated that endoscopic sphincterotomy (EST) combined with large-balloon dilation (LBD) may be a better option than EST alone to manage large bile duct stones. However, limited data were available to compare this combination method with LBD alone in removal of large bile duct stones.

OBJECTIVE

To compare EST plus LBD and LBD alone for the management of large bile duct stones, and analyze the outcomes of each method.

PATIENTS AND METHODS

Sixty-one patients were included in the EST plus LBD group, and 48 patients were included in the LBD alone group retrospectively. The therapeutic success, clinical characteristics, procedure-related parameters and adverse events were compared.

RESULTS

Compared with EST plus LBD, LBD alone was more frequently performed in patients with potential bleeding diathesis or anatomical changes (P = 0.021). The procedure time from successful cannulating to complete stone removal was shorter in the LBD alone group significantly (21.5 vs. 17.3 min, P = 0.041). The EST plus LBD group and the LBD alone group had similar outcomes in terms of overall complete stone removal (90.2% vs. 91.7%, P = 1.000) and complete stone removal without the need for mechanical lithotripsy (78.7% vs. 83.3%, P = 0.542). Massive bleeding occurred in one patient of the EST plus LBD group, and successfully coagulated. Postoperative pancreatitis did not differ significantly between the EST plus LBD group and the LBD alone group (4.9% vs. 6.3%; P = 1.000).

CONCLUSION

Endoscopic sphincterotomy combined with LBD offers no significant advantage over LBD alone for the removal of large bile duct stones. LBD can simplify the procedure compared with EST plus LBD in terms of shorten the procedure time.

Submucosal tunneling endoscopic resection for upper gastrointestinal multiple submucosal tumors originating from the muscular propria layer: a feasibility study

BACKGROUND AND AIMS

In recent years, submucosal tunneling endoscopic resection (STER) was applied more and more often for single gastrointestinal (GI) submucosal tumor (SMT). However, little is known about this technique for treating multiple SMTs in GI tract. In the present study, we investigated the feasibility and outcome of STER for upper GI multiple SMTs originating from the muscularis propria (MP) layer.

PATIENTS AND METHODS

A feasibility study was carried out including a consecutive cohort of 23 patients with multiple SMTs from MP layer in esophagus, cardia, and upper corpus who were treated by STER from June 2011 to June 2014. Clinicopathological, demographic, and endoscopic data were collected and analyzed.

RESULTS

All of the 49 SMTs were resected completely by STER technique. Furthermore, only one tunnel was built for multiple SMTs of each patient in this study. En bloc resection was achieved in all 49 tumors. The median size of all the resected tumors was 1.5 cm (range 0.8-3.5 cm). The pathological results showed that all the tumors were leiomyoma, and the margins of the resected specimens were negative. The median procedure time was 40 min (range: 20-75 min). Gas-related complications were of the main complications, the rates of subcutaneous emphysema and pneumomediastinum, pneumothorax, and pneumoperitoneum were 13.0%, 8.7% and 4.3%. Another common complication was thoracic effusion that occurred in 2 cases (8.7%), among which only 1 case (4.3%) with low-grade fever got the drainage. Delayed bleeding, esophageal fistula or hematocele, and infection in tunnel were not detected after the operation there were no treatment-related deaths. The median hospital stay was 4 days (range, 2-9 days). No residual or recurrent lesion was found during the follow-up period (median 18, ranging 3-36 months).

CONCLUSION

Submucosal tunneling endoscopic resection is a safe and efficient technique for treating multiple esophageal SMTs originating from MP layer, which can avoid patients suffering repeated resections.

Self-priming on the plant viral RNAs during reverse transcription-PCR

The occurrence of the primer-independent cDNA synthesis during RT-PCR analysis of human and animal RNA viruses has been well documented. Conversely, there is scant knowledge about this event in plant RNA viruses. Here we show that the primer-independent cDNA synthesis occurs in all eight different plant RNA viruses tested in this study, suggesting a common phenomenon for RT-PCR analysis of plant RNA viruses. Additional experiments indicate that the event is likely contributed to by RNA self-priming, and can be effectively reduced or eliminated through increasing temperature of the RT reaction.

A cultured endophyte community is associated with the plant Clerodendrum inerme and antifungal activity

Fungal endophytes live in the inner tissues of Clerodendrum inerme and may be significant resources for new chemicals in drug discovery. A total of 242 endophytic fungi were recovered from 602 sample segments of C. inerme; 66 were purified. The 66 fungi belonging to 16 taxa and 11 genera (Alternaria, Nigrospora, Bartalinia, Pestalotiopsis, Fusarium, Mycoleptodiscus, Trichoderma, Phomopsis, Diaporthe, Lasiodiplodia, and Curvularia) were identified by morphological characteristics and fungal internal transcribed spacer sequences. The most abundant genera were Alternaria and Lasiodiplodia. Some of the endophytes exhibited tissue specificity. The colonization frequencies of endophytes in the stems were evidently higher than those in the roots and leaves. The crude ethyl acetate extracts were tested against 6 endophytes isolated from C. inerme. Three of 10 (33.3%) endophytes, which were identified as Phomopsis sp, Curvularia sp, and Mycoleptodiscus sp, displayed distinct antifungal activity against ≥3 tested fungi. To our knowledge, this is the first report of an endophytic community associated with C. inerme in China and its antifungal activity in vitro.

Involvement of the mitfa gene in the development of pigment cell in Japanese ornamental (Koi) carp (Cyprinus carpio L.)

A colored phenotype is an important feature of ornamental fish. In mammals, microphthalmia-associated transcription factor (MITF) was found to regulate the development of melanocytes. In this study, the mitfa cDNA was first cloned from the Japanese ornamental (Koi) carp (Cyprinus carpio L.), an important ornamental freshwater fish. The full-length cDNA of the mitfa gene contains 1634 bp, coding for 412 amino acids in Koi. The identity degree of mitfa amino acid sequences between the Koi carp and zebrafish is 92.9%. We tested the expression of the mitfa gene in several varieties of Koi using reverse transcription-polymerase chain reaction and found that the mitfa gene is highly expressed in the skin tissues of the Taisho sanke and the Procypris merus. Interestingly, the mitfa gene was also expressed in the Kohaku and Yamabaki ogon, although melanocytes were not observed in the skin. Koi carp embryos were transparent and colorless, while after hatching, different types of pigment cells successively emerged in a fixed order. In Taisho sanke, melanocytes first appeared in the trunk at approximately 12 days of age. Subsequently, there was a large area of melanocytes by 30 days of age. The expression level of the mitfa mRNA was low in early embryos and newly hatched larvae, and increased to high levels in 30-day-old fry. The results show that the mitfa gene is involved in regulating fish body color in the development of both melanocytes and pigment cells.

Garlic for hypertension: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

In the past decade, garlic has become one of the most popular complementary therapies for blood pressure (BP) control used by hypertensive patients. Numerous clinical studies have focused on the BP-lowering effect of garlic, but results have been inconsistent. Overall, there is a dearth of information available to guide the clinical community on the efficacy of garlic in hypertensive patients.

AIM

To systematically review the medical literature to investigate the current evidence of garlic for the treatment of hypertension.

METHODS

PubMed, the Cochrane Library and EMBASE were searched for appropriate articles from their respective inceptions until August 2014. Randomized, placebo-controlled trials comparing garlic vs. a placebo in patients with hypertension were considered. Papers were independently reviewed by two reviewers and were analyzed using Cochrane software Revman 5.2.

RESULTS

A total of seven randomized, placebo-controlled trials were identified. Compared with the placebo, this meta-analysis revealed a significant lowering effect of garlic on both systolic BP (WMD: -6.71 mmHg; 95% CI: -12.44 to -0.99; P = 0.02) and diastolic BP (WMD: -4.79 mmHg; 95% CI: -6.60 to -2.99; P < 0.00001). No serious adverse events were reported in any of the trials.

CONCLUSION

The present review suggests that garlic is an effective and safe approach for hypertension. However, more rigorously designed randomized controlled trials focusing on primary endpoints with long-term follow-up are still warranted before garlic can be recommended to treat hypertensive patients.

Bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis of randomized controlled trials

There has been concern regarding the use of controversial paradigms for repetitive transcranial magnetic stimulation (rTMS) to manage treatment-resistant depression (TRD). This meta-analysis assessed the efficacy of bilateral rTMS compared with unilateral and sham rTMS in patients with TRD. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, EAGLE and NTIS databases were searched to identify relevant studies, and randomized controlled trials (RCTs) on bilateral rTMS for TRD patients were included. The response was defined as the primary outcome, and remission was the secondary outcome. Ten RCTs that included 634 patients met the eligibility criteria. The risk ratio (RRs) of both the primary and secondary outcomes of bilateral rTMS showed non-significant increases compared to unilateral rTMS (RR=1.01, P=0.93; odds ratio [OR]=0.77, P=0.22). Notably, the RR of the primary bilateral rTMS outcome was significantly increased compared to that for sham rTMS (RR=3.43, P=0.0004). The results of our analysis demonstrated that bilateral rTMS was significantly more effective than sham rTMS but not unilateral rTMS in patients with TRD. Thus, bilateral rTMS may not be a useful paradigm for patients with TRD.

Carbon dioxide enrichment alleviates heat stress by improving cellular redox homeostasis through an ABA-independent process in tomato plants

Plant responses to elevated CO₂ and high temperature are critically regulated through a complex network of phytohormones and redox homeostasis. However, the involvement of abscisic acid (ABA) in plant adaptation to heat stress under elevated CO₂ conditions has not been thoroughly studied. This study investigated the interactive effects of elevated CO₂ (800 μmol·mol(-1) ) and heat stress (42 °C for 24 h) on the endogenous level of ABA and the cellular redox state of two genotypes of tomato with different ABA biosynthesis capacities. Heat stress significantly decreased maximum photochemical efficiency of PSII (Fv/Fm) and leaf water potential, but also increased levels of malondialdehyde (MDA) and electrolyte leakage (EL) in both genotypes. Heat-induced damage was more severe in the ABA-deficient mutant notabilis (not) than in its parental cultivar Ailsa Craig (Ailsa), suggesting that a certain level of endogenous ABA is required to minimise the heat-induced oxidative damage to the photosynthetic apparatus. Irrespective of genotype, the enrichment of CO₂ remarkably stimulated Fv/Fm, MDA and EL in heat-stressed plants towards enhanced tolerance. In addition, elevated CO₂ significantly strengthened the antioxidant capacity of heat-stressed tomato seedlings towards a reduced cellular redox state for a prolonged period, thereby mitigating oxidative stress. However, elevated CO₂ and heat stress did not alter the endogenous level of ABA or the expression of its biosynthetic gene NCED2 in either genotype, indicating that ABA is not involved in elevated CO₂ -induced heat stress alleviation. The results of this study suggest that elevated CO₂ alleviated heat stress through efficient regulation of the cellular redox poise in an ABA-independent manner in tomato plants.

Ginkgo biloba extract for essential hypertension: a systemic review

BACKGROUND

Ginkgo biloba extract (GBE), a traditional natural herbal product, is often used in the treatment of essential hypertension (EH) as complementary therapy in China and European countries.

AIM

To critically assess the current clinical evidence of efficacy and safety of GBE for EH.

METHODS

7 electronic databases (Cochrane Library, PubMed, EMBASE, VIP, CBM, Wanfang data, and CNKI) were searched to identify randomized controlled trials (RCTs) of GBE for EH. Methodological quality was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

A total of 9 RCTs with 1012 hypertensive patients were identified and reviewed. Most RCTs were of high risk of bias with flawed study design and poor methodological quality. 6 trials demonstrated potential positive effect of GBE as complementary therapy on BP reduction when compared with antihypertensive drug therapy; however, it was not associated with a statistically significant effect on both SBP and DBP reduction in 3 other trials. Despite the positive findings, there were so many methodological limitations and significant clinical heterogeneity. Most of the trials did not report adverse effects, and the safety of GBE is still uncertain.

CONCLUSION

No confirmative conclusions on the efficacy and safety of GBE for EH could be drawn. More rigorous trials are warranted to support their clinical use.

The anti-inflammatory effect of cherry blossom extract (Prunus yedoensis) used in soothing skincare product

OBJECTIVE

Previous investigations suggested that cherry blossoms could provide valuable bioactive materials. However, few observations regarding the anti-inflammatory effect of cherry blossoms were reported. This study was to explore the anti-inflammatory effect of cherry blossom extract (CBE), which was used as a soothing ingredient in skincare product.

METHODS

In vitro study, the anti-inflammatory effect of CBE on the nitric oxide (NO) inhibition assay in lipopolysaccharide (LPS)-treated RAW 264.7 cells was investigated. In vivo study, 40 volunteers were included in a randomized, single-blinded, placebo-controlled trial. 24-hour-occlusive test chambers were applied on the flexor side of the forearm with 3% sodium lauryl sulphate (SLS). Subsequently, the test areas were treated on 9 subsequent days with a cream containing 3% CBE or a placebo. Evaluation included a visual score and determination of erythema value (E value).

RESULTS

In vitro study, 2% CBE reduced NO production by 31.83% compared to the placebo. In the SLS irritant patch test, the visual score and erythema value of CBE were lower than that of the placebo on D5 and D9.

CONCLUSION

Cherry blossom extract shows good anti-inflammatory effect in vitro and in vivo and represents a promising functional ingredient in soothing skincare product by reducing skin inflammation.

Polymorphysims of CYP17-I Gene in the Exons Were Associated with the Reproductive Endocrine of Japanese Flounder (Paralichthys olivaceus)

The cytochrome P450c17-I (CYP17-I) is one of the enzymes critical to gonadal development and the synthesis of androgens. Two single nucleotide polymorphisms (SNPs) were detected within the coding region of the CYP17-I gene in a population of 75 male Japanese flounder (Paralichthys olivaceus). They were SNP1 (c.C445T) located in exon2 and SNP2 (c.T980C (p.Phe307Leu)) located in exon5. Four physiological indices, which were serum testosterone (T), serum 17β-estradiol (E₂), Hepatosomatic index (HSI), and Gonadosomatic index (GSI), were studied to examine the effect of the two SNPs on the reproductive endocrines of Japanese flounder. Multiple comparisons revealed that CT genotype of SNP1 had a much lower T level than CC genotype (p<0.05) and the GSI of individuals with CC genotype of SNP2 was higher than those with TT genotype (p<0.05). Four diplotypes were constructed based on the two SNPs and the diplotype D3 had a significantly lower T level and GSI. In conclusion, the two SNPs were significantly associated with reproductive traits of Japanese flounder.

Massage therapy for essential hypertension: a systematic review

Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); P<0.0001) and diastolic BP (MD: -3.63 (-6.18, -1.09); P=0.005); massage appears beneficial for reducing SBP (MD: -3.47 (-5.39, -1.56); P=0.0004) for hypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future.

Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study

BACKGROUND AND STUDY AIMS

Recurrence/persistence of symptoms occurs in approximately 20 % of patients after Heller myotomy for achalasia. Controversy exists regarding the therapy for patients in whom Heller myotomy has failed. The aim of the current study was to evaluate the efficacy and feasibility of peroral endoscopic myotomy (POEM), a new endoscopic myotomy technique, for patients with failed Heller myotomy.

PATIENTS AND METHODS

A total of 12 patients with recurrence/persistence of symptoms after Heller myotomy, as diagnosed by established methods and an Eckardt score of ≥ 4, were prospectively included. The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤ 3. Secondary outcomes were procedure-related adverse events, lower esophageal sphincter (LES) pressure on manometry, reflux symptoms, and medication use before and after POEM.

RESULTS

All 12 patients underwent successful POEM after a mean of 11.9 years (range 2 - 38 years) from the time of the primary Heller myotomy. No serious complications related to POEM were encountered. During a mean follow-up period of 10.4 months (range 5 - 14 months), treatment success was achieved in 11/12 patients (91.7 %; mean score pre- vs. post-treatment 9.2 vs. 1.3; P < 0.001). Mean LES pressure was 29.4 mmHg pre-treatment and 13.5 mmHg post-treatment (P < 0.001). One patient developed mild reflux symptoms and required intermittent medication with proton pump inhibitors.

CONCLUSIONS

POEM seems to be a promising new treatment for failed Heller myotomy resulting in short-term symptom relief in > 90 % of cases. Previous Heller myotomy may make subsequent endoscopic remyotomy more challenging, but does not prevent successful POEM.

Evaluation of all-inorganic CdSe quantum dot thin films for optoelectronic applications

Exchanging the original organic ligands of colloidal CdSe quantum dots (QDs) with inorganic metal chalcogenide SnS(4) ligands resulted in absorption peak redshifts and complete photoluminescence (PL) quenching in QD solids. The SnS(4)-capped QDs, meanwhile, were able to retain strong excitonic absorption. After the ligand exchange, the ITO/QDs/Al structure showed much higher electrical conductivity and reduced space-charge limited current. Its photocurrent spectral response increased by over two orders of magnitude and closely resembled the absorption spectrum of the QDs. However, it was found that mild thermal treatment above 200 °C transformed the SnS(4)-capped QD film into to a more conductive assembly, degrading its absorption and photocurrent generation. These results suggest that the inorganic ligands considerably enhanced the inter-dot electronic coupling in QD solids, leading to facile charge separation and transport. Our study thus demonstrates the potential applicability of colloidal QDs with metal chalcogenide ligands processed at low temperatures for efficient photodetection and solar energy conversion.