Investigating the safety and efficacy of nerve stimulation for management of groin pain after surgical herniorrhaphy: a systematic review and meta-analysis

PURPOSE

Chronic post-operative inguinal pain (CPIP) following inguinal hernia repair has been a major sequela affecting 4000-48000 patients annually. Optimal management of CPIP has been a challenge, and pharmacological management particularly with opioids has shown unsatisfactory results. The main objective of this systematic review is to investigate the safety and efficacy of neuromodulation as an alternative intervention for the management of post-operative inguinal pain.

METHODS

A literature search was conducted by three reviewers to identify all relevant studies on the use of neuromodulatory interventions for treating post-operative inguinal pain. Data on study characteristics, neuromodulatory modalities, and patient's clinical data such as pre/post-interventional pain scores and analgesic requirements were extracted and reported.

RESULTS

A total of 389 patients with 357 (95.9%) males and 15 (4.1%) females were evaluated. The mean age of study participants was 47.9 ± 10.4 years. There were 187 (48.1%) and 202 (51.9%) patients allocated to the control and trial groups, respectively. The most common neuromodulation modality was TENS (4, 36.4%), followed by SCS (3, 27.3%), PNS (3, 27.3%), and acupuncture-assisted (2, 18.2%). The overall mean follow-up duration of the entire cohort was 3.8 months. The mean difference between pre-operative and post-operative VAS scores in the trial groups was 4.65 (95% Confidence Interval [CI], 2.97, 6.33), which was statistically significant (P value < 0.05). Patient-reported outcome measures showed significant responsiveness toward their treatments.

CONCLUSION

Nerve stimulation, in its many forms, is a safe and feasible option for the management of post-operative inguinal pain.

The effect of Allium saralicum R. M. Fritsch nanocapsules in yogurt on type 2 diabetes in male rats: physicochemical characterization and pharmacodynamics assessment

To treat illness, people are increasingly turning to natural foods rather than pharmaceuticals. Herbal extracts with antioxidant and anti-diabetic properties could be a good alternative for treating diabetes. The purpose of this study was to look into the effects of ethanol extraction on the Morphology of liver cells and hyperglycemia in rats of Allium saralicum RM Fritsch nanocapsules based on chitosan incorporated with yogurt. In this experimental study, 32 adult Wistar rats were randomly selected. The effect of Nano extraction on hypoglycemia was assessed using blood glucose levels three and fifteen days after a streptozotocin intraperitoneal (60 mg/kg) injection, as well as hepatocyte count and liver tissue morphology. The average size of the chitosan nanoparticles was determined to be 86 nm. After comparing the blood sugar levels of the A. saralicum nanocapsules groups to the untreated diabetes group, a significant decrease was constructed to observe hyperglycemia. Because of increased effective absorption in the intestine, nanocapsules incorporated into yogurt were able to reduce hyperglycemia in diabetic rats. As a result, a new yogurt formulation containing A. saralicum nanocapsules extract is recommended for diabetic patients.

Evaluation of hippocampal arylalkylamine N-acetyltransferase activity in amyloid β neurotoxicity

Arylalkylamine N-acetyltransferase (AANAT), a rate-limiting enzyme in melatonin synthesis, is present in extra-pineal tissues such as the hippocampus. The hippocampal AANAT activity in amyloid β (Aβ) neurotoxicity has not been exactly defined. Adult male rats received bilateral intra-CA1 Aβ administration. The hippocampus tissue sampling was performed 2, 12, and 24 hours after Aβ injection in the morning and night. The inflammation was monitored using TNF-α immunohistochemistry. The AANAT enzyme activity and melatonin levels were measured using western blotting and HPLC. The sampling in the morning versus night showed no significant differences in the AANAT activity. The Aβ increased the area of TNF-α positive staining 24 hours after injection, which indicated the induction of an inflammatory context. It was accompanied by a significant reduction in AANAT activity and hippocampal melatonin. A reverse correlation was also detected between TNF-α and AANAT activity in the 24-hours group. The TNF-α positive area was significantly increased in the 24-hours group as compared to the 12-hours group. Data showed that inflammatory processes began 12 hours after the Aβ injection and augmented 24 hours later. In the second experiment, the impact of Aβ injection on hippocampus AANAT activity was examined in the pinealectomized (PIN×) animals. The PIN× per se did not affect the hippocampal AANAT and melatonin level. However, there was a significant decrease in hippocampal melatonin in the PIN×+Aβ group. The findings suggest the accompanying of hippocampal inflammatory context and AANAT enzyme activity reduction in early stages after Aβ administration. Understanding the underlying mechanism of the decreased AANAT activity may suggest new treatment strategies.

Expression, characterization, and activity optimization of a novel cellulase from the thermophilic bacteria Cohnella sp. A01

Cellulases are hydrolytic enzymes with wide scientific and industrial applications. We described a novel cellulase, CelC307, from the thermophilic indigenous Cohnella sp. A01. The 3-D structure of the CelC307 was predicted by comparative modeling. Docking of CelC307 with specific inhibitors and molecular dynamic (MD) simulation revealed that these ligands bound in a non-competitive manner. The CelC307 protein was purified and characterized after recombinant expression in Escherichia coli (E. coli) BL21. Using CMC 1% as the substrate, the thermodynamic values were determined as K_m 0.46 mM, k_cat 104.30 × 10^-3 (S^-1), and k_cat/K_m 226.73 (M^-1 S^-1). The CelC307 was optimally active at 40 °C and pH 7.0. The culture condition was optimized for improved CelC307 expression using Plackett-Burman and Box-Behnken design as follows: temperature 20 °C, pH 7.5, and inoculation concentration with an OD₆₀₀ = 1. The endoglucanase activity was positively modulated in the presence of Na⁺, Li⁺, Ca²⁺, 2-mercaptoethanol (2-ME), and glycerol. The thermodynamic parameters calculated for CelC307 confirmed its inherent thermostability. The characterized CelC307 may be a suitable candidate for various biotechnological applications.

Tomographic phase and attenuation extraction for a sample composed of unknown materials using x-ray propagation-based phase-contrast imaging

Propagation-based phase-contrast x-ray imaging (PB-PCXI) generates image contrast by utilizing sample-imposed phase-shifts. This has proven useful when imaging weakly attenuating samples, as conventional attenuation-based imaging does not always provide adequate contrast. We present a PB-PCXI algorithm capable of extracting the x-ray attenuation  β and refraction  δ, components of the complex refractive index of distinct materials within an unknown sample. The method involves curve fitting an error-function-based model to a phase-retrieved interface in a PB-PCXI tomographic reconstruction, which is obtained when Paganin-type phase retrieval is applied with incorrect values of δ and β. The fit parameters can then be used to calculate true δ and β values for composite materials. This approach requires no a priori sample information, making it broadly applicable. Our PB-PCXI reconstruction is single-distance, requiring only one exposure per tomographic angle, which is important for radiosensitive samples. We apply this approach to a breast-tissue sample, recovering the refraction component  δ, with 0.6-2.4% accuracy compared with theoretical values.

AMPK signaling in diabetes mellitus, insulin resistance and diabetic complications: A pre-clinical and clinical investigation

Diabetes mellitus (DM) is considered as a main challenge in both developing and developed countries, as lifestyle has changed and its management seems to be vital. Type I and type II diabetes are the main kinds and they result in hyperglycemia in patients and related complications. The gene expression alteration can lead to development of DM and related complications. The AMP-activated protein kinase (AMPK) is an energy sensor with aberrant expression in various diseases including cancer, cardiovascular diseases and DM. The present review focuses on understanding AMPK role in DM. Inducing AMPK signaling promotes glucose in DM that is of importance for ameliorating hyperglycemia. Further investigation reveals the role of AMPK signaling in enhancing insulin sensitivity for treatment of diabetic patients. Furthermore, AMPK upregulation inhibits stress and cell death in β cells that is of importance for preventing type I diabetes development. The clinical studies on diabetic patients have shown the role of AMPK signaling in improving diabetic complications such as brain disorders. Furthermore, AMPK can improve neuropathy, nephropathy, liver diseases and reproductive alterations occurring during DM. For exerting such protective impacts, AMPK signaling interacts with other molecular pathways such as PGC-1α, PI3K/Akt, NOX4 and NF-κB among others. Therefore, providing therapeutics based on AMPK targeting can be beneficial for amelioration of DM.

Design and validation of a tool to assess the safety principles of working with nanomaterials in nanotechnology laboratories

Introduction: The unique properties of nanomaterials, in addition to their applications in science and technology, can be a threat to human health and the environment. Exposure to these materials may occur in workplaces or research laboratories. It can be said that about half of people with occupational exposure to nanomaterials work in academic environments and laboratories. So, the present study was conducted to design and validate a tool to investigate the principles of working safely with nanomaterials in research laboratories. Materials & Methods: The tool was designed using reports, instructions and articles related to " Methods of working safely with nanomaterials". The validity of the tool was assessed using Lawshe method by calculating CVI and CVR. The reliability of the instrument was evaluated using Cronbach's alpha coefficient and kappa coefficient. Results: The tool was designed in 5 sections: "General Information", "Transportation and Storage of Nanomaterials", "Engineering Controls", "Administrative Controls" and "Personal Protection Equipment". After validation, 5 items did not get the necessary points to stay in the tool and were removed. The Cronbach's alpha value for each section of the tool was more than 0.80, indicating that the was "appropriate". Conclusion: According to the results, it seems that the tool studied in this study is compatible for the designed purpose and is ready to be used as a questionnaire or checklist.

Biosensor-based methods for Crimean-Congo hemorrhagic fever virus detection

Crimean-Congo hemorrhagic fever is a tick-borne disease with high fatality rate that is endemic in some parts of Asia, Africa and Europe. Rapid diagnostics of Crimean-Congo hemorrhagic fever (CCHF) is necessary for appropriate clinical management of this disease and also can be useful in preventing of secondary spread from human-to-human, though, common tests which are used to diagnose Crimean-Congo hemorrhagic fever have some limitations. Here we review 1) common diagnostic tests for CCHF, 2) limitations in laboratories methods of CCHF and 3) biosensor researches for detection of CCHF. It is necessary to design and develop an effective, rapid, and also low-cost tool such as biosensor to detect Crimean-Congo hemorrhagic fever. Based on the key role of rapid detection of CCHF in the control of infection, development of a biosensor as a rapid tool seems very major in the diagnosis of CCHF, though, there are limited studies on this field and more researches are needed in this issue.

Chronic stress and Alzheimer's disease

Stress is a key factor in the development and progress of diseases. In neurodegenerative conditions, stress management can play an important role in maintaining the quality of life and the capacity to improve. Neurodegenerative diseases, including Alzheimer's disease, cause the motor and cognitive malfunctions that are spontaneously stressful and also can disturb the neural circuits that promote stress responses. The interruption of those circuits leads to aggressive and inappropriate behavior. In addition, stress contributes to illness and may exacerbate symptoms. In this review, we present stress-activated neural pathways involved in Alzheimer's disease from a clinical and experimental point of view, as well as supportive drugs and therapies.

Shedding light on thyroid hormone disorders and Parkinson disease pathology: mechanisms and risk factors

Parkinson's disease (PD) is a neurodegenerative disorder characterized by loss of dopaminergic neurons. Dopaminergic system is interconnected with the hypothalamic-pituitary-thyroid axis. Dopamine (DA) upregulates thyrotropin releasing hormone (TRH) while downregulating thyroid stimulating hormone (TSH) and thyroid hormones. Moreover, TRH stimulates DA release. PD is associated with impaired regulation of TSH and thyroid hormones (TH) levels, which in turn associate with severity and different subtypes of PD, while levodopa and bromocriptine treatment can interfere with hypothalamic-pituitary-thyroid axis. Thyroid disturbances, including hypothyroidism, Hashimoto's thyroiditis (HT), hyperthyroidism and Graves' disease (GD) not only increase the risk of PD but also share some clinical signs with PD. Also, several genes including RASD2, WSB1, MAPT, GIRK2, LRRK2 and gene products like neurotensin and NOX/DUOX affect the risk for both PD and thyroid disease. Hypothyroidism is associated with obesity, hypercholesterolemia, anemia and altered cerebral blood flow which are associated with PD pathology. Herein we provide a comprehensive view on the association between PD and thyroid hormones regulation and dysregulations, hoping to provide new avenues towards targeted treatment of PD. We performed a comprehensive search in literature using Pubmed and Scopus, yielding to a total number of 36 original articles that had addressed the association between thyroid hormone disorders and PD.

Curcumin-gold-polyethylene glycol nanoparticles as a nanosensitizer for photothermal and sonodynamic therapies: In vitro and animal model studies

Photothermal and ultrasound therapies are novel non-invasive strategies for tumor treatment which are equipped with a photosensitizer and sonosensitizer subsequent activation by laser irradiation and ultrasound exposure. In this study, curcumin-gold-polyethylene glycol nanoparticles (Cur-Au NPs-PEG) were synthesized, and the dual role in photothermal (PTT) and sonodynamic (SDT) therapies of melanoma cancer was evaluated. The toxicity effect of Cur-Au NPs-PEG against a mouse malignant melanoma cell line C540 (B16/F10) was firstly inspected in vitro. Cur-Au NPs-PEG provided a hyperthermal microenvironment and generated reactive oxygen species upon PTT and STD, respectively, with representing synergism effects. Studies in vivo in a tumor-bearing animal also demonstrate the superiority of PTT and SDT in destroying melanoma tumor.

Osteopontin siRNA does not confer resistance to toxic effects of parthenolide in Jurkat cells

BACKGROUND

Osteopontin (OPN) plays a critical role in cell proliferation and drug resistance in cancer treatment and hematological malignancies. In T cell acute lymphoblastic leukemia, most initial therapies can induce remission while some patients then relapse and do not respond well to chemotherapy. The sesquiterpene lactone parthenolide (PTL) can induce apoptosis in a variety of cancer cell lines via inhibition of pro-inflammatory transcription factor nuclear factor kappa B and has anti-tumor activity in acute lymphoblastic leukemia treatment.

AIM

To study the role of OPN in conferring in vitro resistance to PTL in Jurkat cells.

METHODS

Jurkat cells were cultured with 8-20 μm PTL for 48 h. Transfection with OPN siRNA was provided. Apoptosis assays were performed with Annexin V-Alexa Fluor-488/PI. Quantitative real-time polymerase chain reaction was used to measure OPN gene expression using the 2-2^-ΔΔCt method.

RESULTS

PTL has cytotoxic and apoptotic effect on Jurkat cells with IC₅₀ values of 16.1 μm, and growth inhibition effect of PTL does not differ significantly in combination with OPN-siRNA. OPN gene expression is not affected by PTL.

CONCLUSIONS

Parthenolide induces apoptosis in Jurkat cells, but inhibition of osteopontin gene expression with siRNA does not reduce apoptotic effect of parthenolide.

The prevalence of human bocavirus in <2-year-old children with acute bronchiolitis

Acute bronchiolitis is one of the most common lower respiratory tract infections in children with less than 2 years of age. Nowadays, molecular methods provide an opportunity to better understand the etiology of bronchiolitis. Several viral agents including Respiratory syncytial virus (RSV), Rhinovirus, Parainfluenza and Human bocavirus (HBoV) are responsible for acute bronchiolitis. There are growing studies on the prevalence of HBoV in patients with bronchiolitis. The present systematic review and meta-analysis were conducted to determine the pooled prevalence of HBoV in the respiratory samples of children with acute bronchiolitis. A literature search was conducted in the databases of PubMed, Scopus and Web of Science to recruit studies reporting the frequency of HBoV in <2-year-old children with acute bronchiolitis from 2005 to 2019. Only studies that used polymerase chain reaction (PCR)-based methods to detect the virus in nasopharyngeal samples were included. A total of 22 studies assessing 6751 cases were analyzed. According to the meta-analysis based on the random-effects model, the overall prevalence of HBoV in children with <2 years old was obtained 13% (95% CI: 0.09-0.17). Additionally, the rates of single (as the sole organism) and mixed (in combination with other viruses) HBoV infections were 4% and 9%, respectively. This study showed a high rate of HBoV detection in children with acute bronchiolitis. This should be considered as part of a diagnostic test panel for respiratory infections in children with bronchiolitis.

Hemolytic disease of the fetus and newborn caused by anti-Hr0 in a 27-year-old female with Dc- phenotype: A case report

Anti-Hr₀ (Anti-Rh17) is a rare immune Immunoglobulin G (IgG) to high-frequency Rh antigens that may cause severe and often fatal Hemolytic disease of the fetus and newborn (HDFN) in D--, Dc- and DC^w- mothers who have been exposed to red cells of the common Rh phenotype by transfusion or pregnancy. Several pregnant women have been affected by this antibody leading to perinatal death. Therefore, immediate and effective management of these cases is of great importance. We report a case of HDFN in a 27-year-old (G5, P3, L1), woman with Rh Dc- phenotype managed successfully using intravenous immunoglobulin (IVIg) and simple transfusions.

Mothers' willingness to accept and pay for vaccines to their children in western Iran: a contingent valuation study

Background

The clients’ willingness to accept (WTA) and willingness to pay (WTP) for a given good or service can help elicit the monetary value of that good or service. This study aims to assess the WTA and WTP of mothers attending primary health centers for vaccines to their children during 2019 in Kermanshah city, western Iran.

Methods

We conducted a cross-sectional study on a total of 667 mothers attending primary health centers for vaccines to their children aged two to 18 months. A multistage sampling technique was employed to involve the mothers in the study, and data were collected using a self-administrated open-ended questionnaire. The multivariate linear regression model was used to identify the factors associated with the mothers’ WTP and WTA for vaccines to their children.

Results

The study indicated that 94.2 and 93.1% of the mothers respectively had WTA and WTP values greater than zero, with their corresponding mean values of US$ 6.8 and US$ 4.4. The mothers in the higher monthly household income category, mothers born in the urban areas, and being a female child showed statistically significant positive associations with the mothers’ WTA for the vaccines. While there was a statistically significant positive relationship between monthly household income and the mothers’ WTP; a statistically significant negative relationship exists between the mothers’ age and their WTP for the vaccine to their children.

Conclusions

The findings indicated the mothers’ WTA to WTP ratio of greater than one for the vaccines to their children. The most important factor associated with the mothers’ WTA and WTP was the monthly household income. Thus, improving the socio-economic standards of women in the study area might contribute to reinforcing their immunization services seeking behavior to their children.

Comparative physicochemical stability and clinical anti-wrinkle efficacy of transdermal emulgel preparations of 5% sodium ascorbyl phosphate and or ascorbic acid on human volunteers

OBJECTIVES

Antioxidant containing cosmeceuticals are commonly prescribed products in treating wrinkles and revitalizing the skin. The aim of this study was the comparative evaluation of physicochemical stability and clinical anti-wrinkle efficacy of transdermal emulgel preparations of sodium ascorbyl phosphate (SAP) and ascorbic acid (AA) on human volunteers.

METHODS

Emulgel preparations containing 5% of (SAP) and or (AA) were prepared. HPLC analysis was performed for stability evaluations. Clinical anti-wrinkle efficacy of the formulations was examined on human healthy volunteers in crow's feet area. Elasticity and digital images were recorded before and after treatment.

RESULTS

Formulations with added antioxidants and kept in the refrigerator exhibited better stability characteristics. Two-sided blind study and placebo-controlled study showed that both actives were effective in wrinkles depth reduction and also elasticity enhancement but statistically significant difference in the efficacy of the products was not observed.

CONCLUSION

Formulations containing (AA) and or (SAP) both improved elasticity and wrinkles of the skin almost by the same extent, and it is necessary to add antioxidant stabilizing agents to both preparations to reach a desired stability.

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

BACKGROUND

The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy.

METHODS

Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres.

RESULTS

Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention.

CONCLUSION

A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.

P4592Total arterial revascularization in severe coronary artery disease: a 25-years single-center experience

Objective

To evaluate very long-term survival of Total Arterial Revascularization (TAR) in patients with severe coronary artery disease (CAD) undergoing Coronary Artery Bypass Grafting (CABG).

Methods

Between January 1992 and December 2017, 13798 patients aged 70 years or less underwent primary isolated CABG with at least two grafts in our department. Patients receiving TAR were matched by propensity-score analysis to the rest of the population. All pre- and peri-operative data were collected prospectively in our institutional database. Long-term survival was assessed using provincial vital statistics data. The primary outcome was very-long time survival, secondary outcomes were operative mortality and early complications.

Results

Propensity-score matching identified 602 pairs with similar preoperative characteristics. In the matched control group, 65.4% and 30.9% of patients received 1 and 2 arterial grafts, respectively, whereas 3 or more arterial grafts were used in 3.6%. Less distal anastomoses (2.57±0.77 vs 3.39±0.97, p<0.0001) were performed in TAR patients, who therefore had a shorter cross-clamping time (44.2±14.7 vs 52.9±19.6, p<0.0001). Operative mortality was similar (0.5% vs 1.0%, p=0.51) and there was no difference in the rate of mediastinitis (2.5% vs 0.8%, p=0.28)for the TAR and matched control groups, respectively. TAR patients were less likely to receive blood transfusions (34.9% vs 40.7%, p=0.04). The average follow-up was 13.4±6.7 years. Cox-adjusted survival was significantly better in patients receiving TAR compared to the matched population, up to 25 years postoperatively (HR 0.87 [0.86–0.88], p<0.0001, Figure 1).

Figure 1

Conclusion

Total arterial revascularization is not associated with increased perioperative risk of complications and provides long-term survival benefits up to 25 years postoperatively.

Aquatic animal colors and skin temperature: Biology's selection for reducing oceanic dolphin's skin friction drag

There is currently a growing interest in the area of drag reduction. In this work, the thermal effects of body color of some species of aquatics like Orcas and Dusky dolphins are investigated with respect to their swimming routes and geometric and behavioral characteristics. Considering the marine and atmospheric characteristics of these aquatics' routes, a thermal analysis is performed. The surrounding fluxes including the water flux, sun irradiation, and core temperature are considered in an energy balance to determine the skin temperature of the top side of the animal/organism's body. To study the effects of color on the surface temperature of the aquatic species, an experiment is carried out in the water on a flat plate with black and white color. Applying a turbulent analytical solution for heated boundary layers, it will be shown that the black color on the top of the bodies of these marine organisms is very efficient in terms of skin drag reduction. Moreover, to investigate the effects of the temperature on underwater skin friction drag reduction, the turbulent flow is simulated around a flat plate and a 2- dimensional modeled Killer whale at different temperatures. The results show that the top black body color of Orca and Dusky dolphin decreases their skin friction drag by 7%. This study will also provide the reason for this evolution of color scheme of other extremely fast marine animals, such as billfish, whales, and sharks. This method of drag reduction can be considered as one of the effective factors in skin drag reduction of underwater robots.

Identification of chemical compositions in some medicinal plants by GC/MS analysis

Medicinal plantsused in treatment of diseases earlier times, are potential sources of new drugs. In this study, chemical compositions of Echium khuzestanicum, Marrubium anisodan and Echinops cephalotes were identified by Gas Chromatography-Mass Spectrometry(GC/MS).M.anisodanand E.cephalotes aerial organs and E.khuzistanicum flowers were extracted by maceration method. According to the results, 46 kinds of chemical compounds found in methanol extract of E.khuzestanicum. There are mucilage, fatty acids, flavonoid and diterpenes in the flower of E.khuzestanicum. Seventy sixkinds of chemical compounds were found in methanol extract of E.cephalotesincludingaldehydes (7.9%), phenols (7.5%), fatty acids (5.8%) and furfural (5.4%)and86 kinds of chemical compounds found in M.anisodan extract. Furfural, steroids, vitamin B and flavonoids are the main compounds of M.anisodan.

Meta-analysis of the prognostic role of perioperative platelet count in posthepatectomy liver failure and mortality

BACKGROUND

Emerging evidence suggests that the perioperative platelet count (PLT) can predict posthepatectomy liver failure (PHLF). In this systematic review and meta-analysis, the impact of perioperative PLT on PHLF and mortality was evaluated.

METHODS

MEDLINE and Web of Science databases were searched systematically for relevant literature up to January 2018. All studies comparing PHLF or mortality in patients with a low versus high perioperative PLT were included. Study quality was assessed using methodological index for non-randomized studies (MINORS) criteria. Meta-analyses were performed using Mantel-Haenszel tests with a random-effects model, and presented as odds ratios (ORs) with 95 per cent confidence intervals.

RESULTS

Thirteen studies containing 5260 patients were included in the meta-analysis. Two different cut-off values for PLT were used: 150 and 100/nl. Patients with a perioperative PLT below 150/nl had higher PHLF (4 studies, 817 patients; OR 4·79, 95 per cent c.i. 2·89 to 7·94) and mortality (4 studies, 3307 patients; OR 3·78, 1·48 to 9·62) rates than patients with a perioperative PLT of 150/nl or more. Similarly, patients with a PLT below 100/nl had a significantly higher risk of PHLF (4 studies, 949 patients; OR 4·65, 2·60 to 8·31) and higher mortality rates (7 studies, 3487 patients; OR 6·35, 2·99 to 13·47) than patients with a PLT of 100/nl or greater.

CONCLUSION

A low perioperative PLT correlates with higher PHLF and mortality rates after hepatectomy.

Benchmarking of Siemens Linac in Electron Modes: 8-14 MeV Electron Beams

BACKGROUND

Radiation therapy using electron beams is a promising method due to its physical dose distribution. Monte Carlo (MC) code is the best and most accurate technique for forespeaking the distribution of dose in radiation treatment of patients.

MATERIAL AND METHODS

We report an MC simulation of a linac head and depth dose on central axis, along with profile calculations. The purpose of the present research is to carefully analyze the application of MC methods for the calculation of dosimetric parameters for electron beams with energies of 8-14 MeV at a Siemens Primus linac. The principal components of the linac head were simulated using MCNPX code for different applicators.

RESULTS

The consequences of measurements and simulations revealed a good agreement. Gamma index values were below 1 for most points, for all energy values and all applicators in percent depth dose and dose profile computations. A number of states exhibited rather large gamma indices; these points were located at the tail of the percent depth dose graph; these points were less used in in radiotherapy. In the dose profile graph, gamma indices of most parts were below 1. The discrepancies between the simulation results and measurements in terms of Z_max, R₉₀, R₈₀ and R₅₀ were insignificant. The results of Monte Carlo simulations showed a good agreement with the measurements.

CONCLUSION

The software can be used for simulating electron modes of a Siemens Primus linac when direct experimental measurements are not feasible.

Anti-Inflammatory Effects of Curcumin on Insulin Resistance Index, Levels of Interleukin-6, C-Reactive Protein, and Liver Histology in Polycystic Ovary Syndrome-Induced Rats

OBJECTIVES

Curcumin protects the liver against injury and fibrosis through suppressing hepatic inflammation, attenuating hepatic oxidative stress (OS), and inhibiting hepatic stellate cells (HSCs) activation. Non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) are considered as common metabolic disorders. Low-grade chronic inflammation with different markers, such as elevated C-reactive protein (CRP) and interleukin-6 (IL-6) levels, play a crucial role in PCOS. This study aimed to evaluate the therapeutic effects of curcumin on IL-6 and CRP levels as well as insulin resistance (IR) index on liver function in PCOS rats.

MATERIALS AND METHODS

In this experimental study, 90 adult Wistar rats were divided into control (n=18), sham (n=18), PCOS (n=18) and curcumin-treated PCOS groups (n=36). PCOS group was injected subcutaneously with 2 mg estradio-valerate (E2V). After 60 days, PCOS group was treated with curcumin [100 and 300 mg/kg body weight (BW)] for 14 days and anesthetized by chloroform. Blood and liver samples were collected for histological and serological analyses. Data were analyzed using In-Stat 3 via one-way analysis of variance (ANOVA).

RESULTS

Histological and serological analyses showed a reduction in number of necrotic cells, IR index, as well as IL-6 and CRP levels in PCOS rats that were treated with various concentrations of curcumin.

CONCLUSIONS

In this study, curcumin decreased liver inflammation by induction of insulin sensitivity and reduction of hepatic necrosis. Therefore, curcumin may be considered as protective factor against inflammatory state of PCOS.

Immunomodulation in systemic lupus erythematosus: induction of M2 population in monocyte-derived macrophages by pioglitazone

Macrophages have recently gained attention in systemic lupus erythematosus (SLE) pathogenesis for their role in the anti-inflammatory clearance of apoptotic cells. The M1/M2 polarization of macrophages improves efferocytic capability. Peroxisome proliferator-activated receptor γ is proposed to function in the expansion of the M2 subpopulation. Pioglitazone is a peroxisome proliferator-activated receptor γ agonist with a variety of anti-inflammatory effects. In this paper, we investigated the ex vivo alterations of monocyte-derived macrophages of 15 newly diagnosed SLE patients and 10 normal subjects triggered by apoptotic cells among SLE patients following pioglitazone treatment. The phagocytosis capacity of macrophages and M1/M2 polarization (CD86/CD163) was evaluated. The supernatants were also analyzed for the expression of interleukin (IL)-10, IL-12, transforming growth factor β1 and TNF-α. The mRNA expression of IL-1β and mannose receptor C-type 1 were also quantified among treated and non-treated monocyte-derived macrophages. We found that efferocytosis is defective among monocyte-derived macrophages of SLE patients and might be a major underlying mechanism involved in the sustained inflammation. Pioglitazone could enhance alternative activation of monocyte-derived macrophages and consequently immunomodulation in these patients.

The Effect of Curcumin on TNF-α, IL-6 and CRP Expression in a Model of Polycystic Ovary Syndrome as an Inflammation State

BACKGROUND

Having low-grade chronic inflammation such as elevated C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) plays a crucial role in polycystic ovary syndrome (PCOS). This study aimed at investigating the therapeutic effects of curcumin on IL-6, CRP and TNF-α and symptoms of polycystic ovary syndrome.

METHODS

In this research, 72 female adult Wistar rats were divided into control (n=12), PCOS (n=12) and curcumin-treated PCOS groups (n=48). PCOS was induced by injection of estradiol valerate (2 mg/kg-one-step). PCOS rats were divided into control and experimental groups which received daily intraperitoneal injection of curcumin. After 60 days of syndrome induction, ovaries were collected for histological and immunohistochemical evaluations. Serum IL-6 and CRP was detected by the ELISA kit. Data were analyzed using In-Stat 3 via one-way analysis of variance (ANOVA) and p<0.05 was considered statistically significant.

RESULTS

Histological studies showed a significant reduction in thickness of theca layer and increase in the number of corpus luteum (CL) diameter in the curcumin-treated group compared with the PCOS group; also inflammatory markers such as IL-6 and CRP significantly decreased in groups treated with curcumin compared with PCOS groups. Regarding immunohistochemical analysis, the expression of TNF-α in granulosa layer and follicular fluid of follicles and ovarian cysts in PCOS group was more than the control group's expression. However, expression of this factor in the ovaries treated with curcumin was decreased.

CONCLUSION

This study showed that the anti-inflammatory and antioxidant effects of curcumin on PCOS may be due to its inhibitory effect on expression and levels of TNF-α, serum IL-6 and CRP.

An odd very early marjolin's ulcer after minimal hand burn

Marjolin's ulcer refers to any malignant transformation of chronic wounds. Different chronic wounds may be transformed into malignancies, although they usually have a latency period of between 25 to 40 years after the primary injury. We herein present an otherwise healthy man who developed squamous cell carcinoma (SCC) three weeks after burn injury. It is an interesting case because of this acute transformation into SCC, and may be considered as different to the usual presentation of Marjolin's ulcers.

Elegant pH-Responsive Nanovehicle for Drug Delivery Based on Triazine Dendrimer Modified Magnetic Nanoparticles

Owing to properties of magnetic nanoparticles and elegant three-dimensional macromolecule architectural features, dendrimeric structures have been investigated as nanoscale drug delivery systems. In this work, a novel magnetic nanocarrier, generation two (G2) triazine dendrimer modified Fe₃O₄@SiO₂ magnetic nanoparticles (MNP-G2), was designed, fabricated, and characterized by Fourier transform infrared (FT-IR), thermal gravimetric analysis (TGA), vibrating sample magnetometer (VSM), field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), and dynamic light scattering (DLS). The prepared MNP-G2 nanosystem offers a new formulation that combines the unique properties of MNPs and triazine dendrimer as a biocompatible material for biomedical applications. To demonstrate the potential of MNP-G2, the nanoparticles were loaded with methotrexate (MTX), a proven chemotherapy drug. The MTX-loaded MNP-G2 (MNP-G2/MTX) exhibited a high drug-loading capacity of MTX and the excellent ability for controlled drug release. The cytotoxicity of MNP-G2/MTX using an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide based assay and MCF-7, HeLa, and Caov-4 cell lines revealed that MNP-G2/MTX was more active against the tumor cells than the free drug in a mildly acidic environment. The results of hemolysis, hemagglutination, and coagulation assays confirmed the good blood safety of MNP-G2/MTX. Moreover, the cell uptake and intracellular distribution of MNP-G2/MTX were studied by flow cytometry analysis and confocal laser scanning microscopy (CLSM). This research suggests that MNP-G2/MTX with good biocompatibility and degradability can be selected as an ideal and effective drug carrier in targeted biomedicine studies especially anticancer applications.

[Computational neuroanatomy and microstructure imaging using magnetic resonance imaging]

BACKGROUND

Current computational neuroanatomy focuses on morphological measurements of the brain using standard magnetic resonance imaging (MRI) techniques. In comparison quantitative MRI (qMRI) typically provides a better tissue contrast and also greatly improves the sensitivity and specificity with respect to the microstructural characteristics of tissue.

OBJECTIVE

Current methodological developments in qMRI are presented, which go beyond morphology because this provides standardized measurements of the microstructure of the brain. The concept of in-vivo histology is introduced, based on biophysical modelling of qMRI data (hMRI) for determination of quantitative histology-like markers of the microstructure.

RESULTS

The qMRI metrics can be used as direct biomarkers of the microstructural mechanisms driving observed morphological findings. The hMRI metrics utilize biophysical models of the MRI signal in order to determine 3‑dimensional maps of histology-like measurements in the white matter.

CONCLUSION

Non-invasive brain tissue characterization using qMRI or hMRI has significant implications for both scientific and clinical applications. Both approaches improve the comparability across sites and time points, facilitate multicenter and longitudinal studies as well as standardized diagnostics. The hMRI is expected to shed new light on the relationship between brain microstructure, function and behavior both in health and disease. In the future hMRI will play an indispensable role in the field of computational neuroanatomy.

Protective effect of crocin and voluntary exercise against oxidative stress in the heart of high-fat diet-induced type 2 diabetic rats

Background Oxidative stress plays a critical role in the pathogenesis and progression of type 2 diabetes and diabetic-associated cardiovascular complications. This study investigated the impact of crocin combined with voluntary exercise on heart oxidative stress indicator in high-fat diet-induced type 2 diabetic rats. Materials and methods Rats were divided into four groups: diabetes, diabetic-crocin, diabetic-voluntary exercise, diabetic-crocin-voluntary exercise. Type 2 diabetes was induced by high-fat diet (4 weeks) and injection of streptozotocin (intraperitoneally, 35 mg/kg). Animals received crocin orally (50 mg/kg); voluntary exercise was performed alone or combined with crocin treatment for 8 weeks. Finally, malondialdehyde (MDA), activity of antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were measured spectrophotometrically. Results Treatment of diabetic rats with crocin and exercise significantly decreased the levels of MDA (p < 0.001) and increased the activity of SOD, GPx, and CAT compared with the untreated diabetic group. In addition, combination of exercise and crocin amplified their effect on antioxidant levels in the heart tissue of type 2 diabetic rats. Conclusion We suggest that a combination of crocin with voluntary exercise treatment may cause more beneficial effects in antioxidant defense system of heart tissues than the use of crocin or voluntary exercise alone.

Block ionomer micellar nanoparticles from double hydrophilic copolymers, classifications and promises for delivery of cancer chemotherapeutics

A class of double hydrophilic copolymers comprising ionic and nonionic water-soluble blocks, which are also called block ionomers, represent an interesting type of polymer assembly forming stable, homogeneous core-corona dispersions. They exhibit the solution behavior of normal polyelectrolytes, whereas assembly into micelle, vesicle or disk morphology happens by an external stimulus (pH, temperature or ionic strength) or complex formation with metal ions, ionic surfactants, polyelectrolytes, etc. Temperature, pH, redox or salt sensitivity affords a unique opportunity to control the triggered release of payloads accommodated through electrostatic interaction, coordination or chemical conjugation. Moreover, the non-ionic block provides the surface passivation, prolongation of the blood circulation and tumor accumulation, supporting targeted delivery of chemotherapeutic agents based on pathophysiology of tumor microenvironment. Potentiation of antitumor activity, sensitization of the resistant tumors, increased tolerated dose and translation into clinical practice are among their most intriguing characteristics. Their high functionality has been suggested for co-delivery of multiple agents for reversal of chemo-resistance as well as simultaneous therapy and diagnostics. Nevertheless, some stability concerns may be raised due to the polymer disassembly beyond a critical concentration of pH, salt and polyion concentration that can be modulated by introducing crosslinks between the polymer chains (Nano-networks).

Morphological variations of the vermiform appendix in Iranian cadavers: a study from developing countries

BACKGROUND

The vermiform appendix is a worm-like tube containing a large amount of lymphoid follicles. In our knowledge, there is a little standard data about the vermiform appendix in Iranian population. Therefore, the objective of this study was to investigate the normal appendix size in Iranian cadavers.

MATERIALS AND METHODS

A cross-sectional study was undertaken between June 2014 and July 2015, in the autopsy laboratory, Legal Medicine Organisation, Razavi Khorasan province, Iran. A total of 693 cadavers with the mean age of 40.46 ± 20.99 years were divided into 10 groups. After writing down position of the appendix, the length, diameter and weight of the appendix were measured. Statistical analysis was performed using SPSS software.

RESULTS

The mean values of the demographic characteristics included - age: 40.46 ± 20.99 years; weight: 63.47 ± 17.84 kg; height: 159.95 ± 28.23 cm. The mean values of the appendix length, diameter, weight and index in the cadavers were 8.52 ± 2.99 cm, 12.17 ± 4.53 mm, 6.43 ± 3.26 g and 0.013 ± 0.01, respectively. The most common position of the appendix was retrocaecal in 71.7% of cases. Significant correlations were evident between the value of demographic data and appendix size (p < 0.05). The diameter (p = 0.002) and index of the appendix (p = 0.003) showed significant difference between males and females.

CONCLUSIONS

Having standard data on the vermiform appendix is useful for clinicians as well as anthropologists. The findings of the present study can provide information about morphologic variations of the appendix in Iranian population.

Synthesis, Biological Evaluation, and Molecular Docking Studies on the DNA Binding Interactions of Platinum(II) Rollover Complexes Containing Phosphorus Donor Ligands

Cyclometalated rollover complexes of the type [PtMe(κ² N,C-bipyO-H)(L)] [bipyO-H=cyclometalated 2,2'-bipyridine N-oxide; L=tricyclohexylphosphine (PCy₃ , 2 a), 2-(diphenylphosphino)pyridine (PPh₂ py, 2 b), P(OPh)₃ (2 c)] were synthesized by treating [PtMe(κ² N,C-bipyO-H)(SMe₂ )] (1) with various monodentate phosphine and phosphite ligands. These complexes were characterized by NMR spectroscopy, and the structure of 2 a was confirmed by single-crystal X-ray diffraction. Complex 1 was treated with bis(diphenylphosphino)methane (dppm) at a 1:1 ratio to give the corresponding [PtMe(κ² N,C-bipyO-H)(κ¹ P-dppm)] (3 b) complex, in which the dppm ligand acts as a monodentate pendant ligand. The biological activities of these complexes were evaluated against a panel of four standard cancer cell lines: lung carcinoma (A549), ovarian carcinoma (OV-90 and SKOV3), and breast carcinoma (MCF-7). Complexes 2 c and especially 3 b indicated effective potent cytotoxic activity regarding the cell lines. Electrophoresis mobility shift assays and molecular-modeling investigations were performed to determine the specific binding mode and the binding orientation of these alkylating agents to DNA. Detection of cellular reactive oxygen species was also determined.

Aberrant promoter hypermethylation of selected apoptotic genes in childhood acute lymphoblastic leukemia among North Indian population

Promoter hypermethylation mediates gene silencing in many neoplasms. Acute leukemia has been reported to harbor multiple genes aberrantly silenced by hypermethylation.

AIM

In present study, we investigated the prevalence of hypermethylation of caspase-8 (CASP8), TMS1 and DAPK genes in correlation with clinicopathological factors in childhood acute lymphoblastic leukemia (ALL).

MATERIALS AND METHODS

A case-control study has been conducted based on bone marrow and peripheral blood samples from 125 ALL patients and 100 sex-age matched healthy controls. Methylation specific polymerase chain reaction (PCR) and bisulfite sequencing PCR was performed to analyze the methylation status of these genes. Reverse transcription PCR and real time PCR was carried out to determine changes in the mRNA expression level of the genes due to hypermethylation.

RESULTS

Hypermethylation of the 5´CpG islands of the CASP8, TMS1 and DAPK gene promoters was found in 3.2, 6.4, and 13.6% of 125 childhood ALL samples from north Indian population, respectively. There were significant differences in pattern of hypermethylation of TMS1 (p = 0.045) and DAPK (p &lt; 0.001) between patients and healthy controls. Down-regulation of mRNA expression was found in cases in which CASP8, TMS1 and DAPK were hypermethylated.

CONCLUSIONS

The present study indicated the impact of hypermethylation-mediated inactivation of CASP8, TMS1 and DAPK genes, which is associated with risk of childhood ALL. This abnormality occurs in leukemogenesis and it may be used as a biomarker and for predicting the prognosis of ALL.

Parthenolide reduces gene transcription of prosurvival mediators in U937 cells

In acute myeloid leukemia (AML) the functional abnormalities of osteopontin (OPN), NF-kB, PI3K/AKT/mTOR/PTEN pathway or β-catenin have been considered.

AIM

To analyze the response of U937 cells to parthenolide (PTL) through the involvement of expression of OPN protein, RelB, AKT1, mTOR, PTEN and β-catenin genes.

MATERIALS AND METHODS

The U937 cells were treated with PTL at concentrations of 4 μM (IC25) or 6 μM (IC50) and with OPN siRNA for MTT assay and colony forming assay. Western blot analysis using antibodies against OPN was performed with lysates of PTL-treated cells. Quantitative real-time polymerase chain reaction was performed using primers for OPN siRNA, RelB, AKT1, mTOR, PTEN and β-catenin.

RESULTS

PTL reduces OPN protein level and down-regulates RelB mRNA in U937 cell line. Suppression of OPN with siRNA increases the cytotoxic effects of PTL. Also, mRNA expression of AKT1, mTOR, PTEN, and β-catenin decreases with PTL or OPN siRNA.

CONCLUSION

Sensitivity of U937 cells to PTL can be associated with the reduction in expression of prosurvival mediators.

A high performance supercapacitor based on decoration of MoS2/reduced graphene oxide with NiO nanoparticles

GO and MoS₂ solution in combination with NiO nanoparticles present a high performance supercapacitor and excellent cycling stability.

Testosterone and Voluntary Exercise, Alone or Together Increase Cardiac Activation of AKT and ERK1/2 in Diabetic Rats

Background

Impaired angiogenesis in cardiac tissue is a major complication of diabetes. Protein kinase B (AKT) and extracellular signal regulated kinase (ERK) signaling pathways play important role during capillary-like network formation in angiogenesis process.

Objectives

To determine the effects of testosterone and voluntary exercise on levels of vascularity, phosphorylated Akt (P- AKT) and phosphorylated ERK (P-ERK) in heart tissue of diabetic and castrated diabetic rats.

Methods

Type I diabetes was induced by i.p injection of 50 mg/kg of streptozotocin in animals. After 42 days of treatment with testosterone (2mg/kg/day) or voluntary exercise alone or in combination, heart tissue samples were collected and used for histological evaluation and determination of P-AKT and P-ERK levels by ELISA method.

Results

Our results showed that either testosterone or exercise increased capillarity, P-AKT, and P-ERK levels in the heart of diabetic rats. Treatment of diabetic rats with testosterone and exercise had a synergistic effect on capillarity, P-AKT, and P-ERK levels in heart. Furthermore, in the castrated diabetes group, capillarity, P-AKT, and P-ERK levels significantly decreased in the heart, whereas either testosterone treatment or exercise training reversed these effects. Also, simultaneous treatment of castrated diabetic rats with testosterone and exercise had an additive effect on P-AKT and P-ERK levels.

Conclusion

Our findings suggest that testosterone and exercise alone or together can increase angiogenesis in the heart of diabetic and castrated diabetic rats. The proangiogenesis effects of testosterone and exercise are associated with the enhanced activation of AKT and ERK1/2 in heart tissue.