A Pilot Study of an Interactive Virtual Tour Tool for Patient Education Prior to Undergoing High-Dose Rate Brachytherapy for Prostate Cancer

PURPOSE/OBJECTIVE(S)

High-dose rate (HDR) brachytherapy for treatment of prostate cancer is an invasive procedure that can be associated with patient anxiety. Patient education regarding the procedure can allow for better informed decision-making while also decreasing anxiety. We sought to develop and assess the utility of an interactive virtual tour tool that portrays a 360-degree view of the HDR brachytherapy patient experience, with the goals of providing patient education, decreasing patient anxiety, and assisting in wayfinding on the procedure day.

MATERIALS/METHODS

Using a 360-degree camera, we captured multiple photographs that depicted the various hospital locations that a patient would navigate through on the day of their HDR brachytherapy procedure, including the medical center lobby, pre-operative/post-operative units, and the brachytherapy suite. We then compiled these 360-degree photographs using virtual tour software, to allow users to navigate throughout the locations. We added informational text, spoken audio, and videos associated with key staff, objects, and the brachytherapy procedure that allow the users to interact with and learn about these various components within the virtual tour. This tool was accessible via a website link on a computer, tablet, or smartphone and was provided at the time of consult to patients who were planning to undergo HDR brachytherapy for prostate cancer. A questionnaire assessing the tool's ease of use, educational value, wayfinding utility, and ability to improve anxiety and treatment decision-making was conducted prior to and after their procedure.

RESULTS

Preliminary feedback from healthy volunteers is highly positive, with users finding that the tool is easily accessible, user-friendly, improves understanding of HDR brachytherapy, simulates the treatment experience accurately, helps with wayfinding, and has the potential to decrease patient anxiety and increase comfort with the treatment decision. Data from the patient questionnaires are being collected and will be analyzed.

CONCLUSION

A 360-degree virtual tour tool allows for an easily accessible, immersive, and interactive method of patient education on an invasive, anxiety-associated procedure. This has the potential to decrease patient anxiety and improve comfort regarding treatment decision-making. This tool may be applied toward other relatively involved radiotherapy modalities, including gynecologic HDR brachytherapy, respiratory-gated treatments, and CyberKnife stereotactic radiosurgery.

A systematic review of whole disease models for informing healthcare resource allocation decisions

BACKGROUND

Whole disease models (WDM) are large-scale, system-level models which can evaluate multiple decision questions across an entire care pathway. Whilst this type of model can offer several advantages as a platform for undertaking economic analyses, the availability and quality of existing WDMs is unknown.

OBJECTIVES

This systematic review aimed to identify existing WDMs to explore which disease areas they cover, to critically assess the quality of these models and provide recommendations for future research.

METHODS

An electronic search was performed on multiple databases (MEDLINE, EMBASE, the NHS Economic Evaluation Database and the Health Technology Assessment database) on 23rd July 2023. Two independent reviewers selected studies for inclusion. Study quality was assessed using the National Institute for Health and Care Excellence (NICE) appraisal checklist for economic evaluations. Model characteristics were descriptively summarised.

RESULTS

Forty-four WDMs were identified, of which thirty-two were developed after 2010. The main disease areas covered by existing WDMs are heart disease, cancer, acquired immune deficiency syndrome and metabolic disease. The quality of included WDMs is generally low. Common limitations included failure to consider the harms and costs of adverse events (AEs) of interventions, lack of probabilistic sensitivity analysis (PSA) and poor reporting.

CONCLUSIONS

There has been an increase in the number of WDMs since 2010. However, their quality is generally low which means they may require significant modification before they could be re-used, such as modelling AEs of interventions and incorporation of PSA. Sufficient details of the WDMs need to be reported to allow future reuse/adaptation.

A Scoping Review of Item-Level Missing Data in Within-Trial Cost-Effectiveness Analysis

OBJECTIVES

Cost-effectiveness analysis (CEA) alongside randomized controlled trials often relies on self-reported multi-item questionnaires that are invariably prone to missing item-level data. The purpose of this study is to review how missing multi-item questionnaire data are handled in trial-based CEAs.

METHODS

We searched the National Institute for Health Research journals to identify within-trial CEAs published between January 2016 and April 2021 using multi-item instruments to collect costs and quality of life (QOL) data. Information on missing data handling and methods, with a focus on the level and type of imputation, was extracted.

RESULTS

A total of 87 trial-based CEAs were included in the review. Complete case analysis or available case analysis and multiple imputation (MI) were the most popular methods, selected by similar numbers of studies, to handle missing costs and QOL in base-case analysis. Nevertheless, complete case analysis or available case analysis dominated sensitivity analysis. Once imputation was chosen, missing costs were widely imputed at item-level via MI, whereas missing QOL was usually imputed at the more aggregated time point level during the follow-up via MI.

CONCLUSIONS

Missing costs and QOL tend to be imputed at different levels of missingness in current CEAs alongside randomized controlled trials. Given the limited information provided by included studies, the impact of applying different imputation methods at different levels of aggregation on CEA decision making remains unclear.

Cost-effectiveness of screening tools for identifying depression in early pregnancy: a decision tree model

Background

Although the effectiveness of screening tools for detecting depression in pregnancy has been investigated, there is limited evidence on the cost-effectiveness. This is vital in providing full information to decision makers. This study aimed to explore the cost-effectiveness of different screening tools to identify depression in early pregnancy compared to no screening.

Methods

A decision tree was developed to model the identification and treatment pathways of depression from the first antenatal appointment to 3-months postpartum using the Whooley questions, the Edinburgh Postnatal Depression Scale (EPDS) and the Whooley questions followed by the EPDS, compared to no screening. The economic evaluation took an NHS and Personal Social Services perspective. Model parameters were taken from a combination of sources including a cross-sectional survey investigating the diagnostic accuracy of screening tools, and other published literature. Cost-effectiveness was assessed in terms of the incremental cost per quality adjusted life years (QALYs). Cost-effectiveness planes and cost-effectiveness acceptability curves were produced using a net-benefit approach based on Monte Carlo simulations of cost-outcome data.

Results

In a 4-way comparison, the Whooley, EPDS and Whooley followed by the EPDS each had a similar probability of being cost-effective at around 30% for willingness to pay values from £20,000–30,000 per QALY compared to around 20% for the no screen option.

Conclusions

All three screening approaches tested had a higher probability of being cost-effective than the no-screen option. In the absence of a clear cost-effectiveness advantage for any one of the three screening options, the choice between the screening approaches could be made on other grounds, such as clinical burden of the screening options. Limitations include data availability and short time horizon, thus further research is needed.

Clinical trials registration

N/A

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08115-x.

Total bone mineral density is inversely associated with stroke: a family osteoporosis cohort study in rural China

BACKGROUND

The relationship of osteoporosis and stroke is still not fully clarified. Apart from the well-known risk factors for stroke, bone mineral density (BMD) has gained more interest in recent years.

AIM

To further elucidate the relationship between BMD and stroke risk, a prospective cohort study in the Chinese rural population was conducted.

DESIGN

Retrospective analysis of a family osteoporosis cohort.

METHODS

Our subjects were selected from an osteoporosis cohort conducted in Anqing, China. All participants underwent a questionnaire assessment, clinical examinations and laboratory assessments. During the follow-up period, the number of people who had a stroke was recorded. Generalized estimating equation regression analysis was performed to determine the significance of the association between BMD and stroke.

RESULTS

A total of 17868 people were included. A two-way interaction test of sex and BMD on stroke was significant (P = 0.002). There was a significant difference in BMD and stroke morbidity in the male group (P = 0.003). When BMD was assessed as quartiles and the lowest quartile was used as reference, a significantly lower risk for stroke was observed in Q2-4. Notably, no significant difference was observed in female participants with adjusted odds ratio (P > 0.05). The P-value for interaction was calculated. The body mass index (P = 0.014) and waist-to-hip ratio (P = 0.027) were found to be significantly associated with BMD and stroke risk in female participants.

CONCLUSIONS

In Chinese rural areas, total BMD may negatively correlated with stroke, especially in men.

Safety and efficacy of dendritic cell-based immunotherapy (DCVAC/LuCa) combined with carboplatin/pemetrexed for patients with advanced non-squamous non-small-cell lung cancer without oncogenic drivers

Background

Our prospective, open-label, single-arm phase II study investigated the safety and efficacy of DCVAC/LuCa (dendritic cell vaccines for lung cancer) combined with standard carboplatin/pemetrexed in advanced non-squamous (nsq) non-small-cell lung cancer (NSCLC).

Patients and methods

Eligible patients had stage IV nsq NSCLC without oncogenic drivers and had not received prior systemic cancer therapy. Treatment consisted of carboplatin/pemetrexed for up to 6 cycles followed by 21 cycles of pemetrexed maintenance or until progression or intolerance. Non-progression patients after two cycles of chemotherapy started to receive DCVAC/LuCa subcutaneously (s.c.) on day 15 of cycle 3, and thereafter q3w (day 15 of chemotherapy cycles) for up to 15 doses. Dosing of DCVAC/LuCa s.c. varied among patients depending on the baseline number of leucocytes but remained constant for each single patient. Safety was assessed by adverse events (AEs), treatment-related adverse events (TRAEs), serious adverse events (SAEs), and adverse events of special interest (AESIs). Efficacy was measured by overall survival (OS), progression-free survival (PFS), time to progression (TTP), and objective response rate (ORR).

Results

Sixty-one patients were enrolled. In the safety population (n = 60), eight patients (13.33%) had grade 3 or greater TRAEs, and six patients (10.0%) showed SAEs which were not related to leukapheresis or DC vaccination. Six grade 1 AEs were considered to be related to leukapheresis. No AESIs or DCVAC/LuCa-induced AEs were observed. The 2-year survival rate in the modified intention-to-treat population (n = 44) was 52.57%. Median OS was not reached. Median PFS was 8.0 months, median TTP was 10.2 months, and the ORR was 31.82%.

Conclusion

In treatment-naïve stage IV nsq NSCLC patients without oncogenic drivers, the combination of carboplatin/pemetrexed and DCVAC/LuCa was well tolerated and showed promising efficacy. Therefore, a study to prove our immunotherapeutic concept in a randomized phase III trial is planned.

•

We investigated the safety and efficacy of DCVAC/LuCa combined with standard carboplatin/pemetrexed in nsq NSCLC.

•

The combination therapy showed a favorable tolerability profile in a selected Chinese population.

•

The 2-year survival rate in the modified intention-to-treat population (n = 44) was 52.57%.

Response of nutrient resorption of Leymus chinensis to nitrogen and phosphorus addition in a meadow steppe of northeast China

Nutrient resorption, one of the most important strategies for plant nutrient conservation, is significantly affected by soil fertility. However, the effects of experimentally altered soil fertility on plant N and P resorption are poorly understood. The potential nutrient resorption response mechanisms of the dominant species Leymus chinensis to six N addition levels (0, 2.5, 5, 10, 20 and 40 g·N·m^-2 ·year^-1 ), two P addition levels (0 and 10 g P·m^-2 ·year^-1 ) and their interactions were studied after 3 years of treatments in a temperate meadow steppe. In both green leaves and culms, N and P addition significantly increased N and P concentrations, respectively. Nitrogen addition led to a decrease in the N resorption efficiency (NRE) of both leaves and culms. Within each N treatment, P addition decreased the P resorption efficiency (PRE) of both leaves and culms and the NRE of leaves, except in the N2.5 treatment. Both NRE and PRE in leaves were higher than those in culms under N and P addition conditions. The nutrient concentrations and resorption efficiency were significantly correlated with the soil nutrient availability. Our results suggest that plants rely more on nutrient absorption from the soil, reducing the proportion of elements obtained through nutrient resorption in nutrient-rich environments.

Role of miR-214-5p in the migration and invasion of pancreatic cancer cells

OBJECTIVE

To analyze the role of miR-214-5p in proliferation and metastasis of pancreatic cancer (PC) cells, as well as its underlying mechanism.

PATIENTS AND METHODS

30 pairs of PC tissues and adjacent normal tissues were collected in our Department. The expression level of miR-214-5p was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). Biological information analysis and luciferase report gene assay were used to verify potential target genes of miR-214-5p. Cell counting kit-8 (CCK-8) and transwell methods were applied to observe the interference of miR-214-5p on invasion and migration of PC cells. Western blot (WB) assay was applied to determine the expression changes of Jagged 1 (JAG1) and epithelial-mesenchymal transition (EMT)-related genes in PC cells.

RESULTS

QRT-PCR results showed that the expression level of miR-214-5p is significantly down-regulated in PC tissues and cells. Bioinformatics software and luciferase report gene assay identified that JAG1 is a target gene of miR-214-5p. The negative correlation between protein expressions of miR-214-5p and JAG1 was assessed by Western Blot assay. Furthermore, miR-214-5p could suppress cell proliferation, invasion and migration, and it also blocked the EMT in PC cells in vitro. Meanwhile, JAG1 overexpression reversed the inhibitory effects of miR-214-5p on proliferation, invasion and migration of PC cells.

CONCLUSIONS

Overexpressing miR-214-5p could significantly inhibit malignant behavior of PC cells through targeted regulation of JAG1. Thus, miR-214-5p might be a potential therapeutic target for treatment of PC.

Low expression of microRNA-1266 promotes colorectal cancer progression via targeting FTO

OBJECTIVE

To explore the role of microRNA-1266 in colorectal cancer (CRC) and its underlying mechanism.

PATIENTS AND METHODS

The expression level of microRNA-1266 in 48 CRC tissues and paracancerous tissues was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). The relationship between microRNA-1266 expression and basic characteristics of CRC patients was analyzed. The effect of microRNA-1266 on the viability of CRC cells was detected by cell counting kit-8 (CCK-8) assay. Subsequently, a potential target gene for microRNA-1266 was predicted through bioinformatics. Finally, the binding condition between microRNA-1266 and the target gene was verified by RNA binding protein immunoprecipitation (RIP) and luciferase reporter gene assay, respectively.

RESULTS

MicroRNA-1266 was lowly expressed in 48 cases of CRC tissues than that of paracancerous tissues. Clinical data demonstrated that microRNA-1266 expression was correlated to tumor size and TNM of CRC patients. Knockdown of microRNA-1266 promoted proliferation of CRC cells. FTO was predicted to be the target gene for microRNA-1266, which was negatively regulated by microRNA-1266.

CONCLUSIONS

MicroRNA-1266 is lowly expressed in CRC tissues than that of paracancerous tissues. Lowly expressed microRNA-1266 promotes the occurrence and progression of CRC by directly targeting FTO.

Experimental determination of the dispersion of ions from a point source in the environment

The dispersion of ions from a point source has been extensively modelled but there have been very few attempts to experimentally verify the theoretical findings. The main reason for this has been the difficulty of discriminating between cluster ion and charged particle concentrations in the air. In this paper, we describe a novel technique for the experimental determination of the dispersion of ions from a point source in air. Laboratory experiments showed that the lifetime of cluster ions in an aerosol cloud was of the order of minutes. However, once they attached to aerosols, the particles retained the charge for at least 30 min, suggesting that they may be carried long distances in natural winds. A negative air ionizer was used to produce ions and charged particles in an open field in the presence of a steady horizontal wind. A neutral cluster and air ion spectrometer was used to measure cluster ion and charged particle concentrations as a function of downwind distance from the source. The results are broadly consistent with the Gaussian dispersion model for a continuous point source. We estimate that cluster ions can be carried up to a distance of several hundred metres before they fully attach to particles which can then be carried as far as 3-4 km. Therefore, these observations have important bearing on exposure to cluster ions and charged particles downwind of ion sources such as high voltage power lines and busy roads.

Expression and clinical significance of long-non-coding RNA GHET1 in pancreatic cancer

OBJECTIVE

To investigate the expression level and biological function of long non-coding RNA gastric carcinoma high expressed transcript 1 (lncRNA-GHET1) in pancreatic ductal adenocarcinoma (pancreatic cancer for short), to analyze the correlation between the expression of GHET1 and clinicopathological features and to explore the role and clinical significance of GHET1 in the development and progression of pancreatic cancer.

PATIENTS AND METHODS

The relative expression of GHET1 in 5 human pancreatic cancer cell lines was detected by quantitative Real-time polymerase chain reaction (qRT-PCR). The specific interference sequence of GHET1 was designed and transiently transfected into pancreatic cancer cells. qRT-PCR assay was used to detect the interference efficiency. Cell counting kit-8 (CCK-8) assay was used to detect the effect of the interference with GHET1 on the proliferation of pancreatic cancer cells. Flow cytometry was used to detect the effect of the interference with GHET1 on the cycle distribution and apoptosis. qRT-PCR was used to detect the relative expression of GHET1 in pancreatic cancer tissues compared with that in cancer-adjacent tissues. The correlation between the expression of GHET1 and the pathological features of pancreatic cancer patients was analyzed.

RESULTS

The expression of GHET1 in human pancreatic cancer cells was relatively high. The results of CCK-8 showed that the proliferation of tumor cells was inhibited after the interference with GHET1 expression. The results of flow cytometry showed that the expression of GHET1 was blocked at G1/G0 phase, and the apoptosis rate was increased. The results of qRT-PCR showed that the expression of GHET1 was upregulated in pancreatic cancer tissues of 49 out of 64 patients compared with that in cancer-adjacent tissues, and the highly expressed GHET1 was positively correlated with the tumor, node and metastasis (TNM) staging of pancreatic cancer.

CONCLUSIONS

Highly expressed GHET1 promotes the proliferation of pancreatic cancer, inhibits apoptosis and is related to TNM staging. The expression of GHET1 can be used as a potential molecular marker for the prognosis and therapeutic target of pancreatic cancer.

[Recombinant human tumor necrosis factor receptor type Ⅱ-IgG Fc fusion protein for treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene]

Objective: To investigate the efficacy and safety of the recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein (rhTNFR: Fc, etanercept) for the treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) . Methods: In September 2011 to February 2016, 12 patients with OMLDT were treated with etanercept 25 mg, subcutaneous injection, twice per week, doubling of first dose. The course of treatment was 6 weeks. The drug eruption area and severity index (DASI) score, the proportion of patients achieving a 50%, 75% and 90% reduction in DASI (DASI50, DASI75, DASI90) and the serum level of TNF-α were used to assess the efficacy at different times. Adverse reactions were also recorded and evaluated. The results were statistically analyzed by nonparametric Friedman test and repetitive measurement ANOVA using the software SPSS19.0. Results: After 4 weeks treatment, the DASI score decreased form 56.33±7.02 to 0.50±0.91 (P<0.01) . The DASI50, DASI75 and DASI90 were all increased to 12 (100%) . The serum level of TNF-α decreased form (43.74±41.62) pg/ml to (3.03±0.47) pg/ml (P<0.01) . Statistically significant difference was observed from the above indexes. There were no adverse reactions in clinical application. Conclusion: Recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein may be a safe and effective drug in the treatment of OMLDT.

Raman spectroscopy of transition metal dichalcogenides

Raman spectroscopy of transition metal dichalcogenides (TMDs) is reviewed based on our recent theoretical and experimental works. First, we discuss the semi-classical and quantum mechanical description for the polarization dependence of Raman spectra of TMDs in which the optical dipole transition matrix elements as a function of laser excitation energy are important for understanding the polarization dependence of the Raman intensity and Raman tensor. Overviewing the symmetry of TMDs, we discuss the dependence of the Raman spectra of TMDs on layer thickness, polarization, laser energy and the structural phase. Furthermore, we discuss the Raman spectra of twisted bilayer and heterostructures of TMDs. Finally, we give our perspectives on the Raman spectroscopy of TMDs.

Determining the need for rescue intracytoplasmic sperm injection in partial fertilisation failure during a conventional IVF cycle

To explore the need for rescue intracytoplasmic sperm injection (ICSI) in cases of partial fertilisation failure during a conventional in vitro fertilisation cycle, rescue ICSI was performed for cycles with a fertilisation rate of <50%. The data were divided into three groups based on the fertilisation rate: group 1 (0%), group 2 (<25%) and group 3 (>25%). The impact of rescue ICSI on each group was then analysed in terms of ovum fertilisation, embryo development, embryo utilisation and selection of embryos for transfer. Rescue ICSI was performed on 1831 unfertilised oocytes from 313 cycles. The fertilisation rates for group 1, group 2 and group 3 were 74.66, 68.35 and 65.46%, and the rate of polyploidy in the three groups was 8.55, 11.33, and 14.47%. The percentage of embryos that can be transferred from rescue ICSI for group 2 was 38.33%, and this value was higher than those of the other two groups. It is concluded that rescue ICSI is not recommended for patients with an IVF rate of >25% as the procedure is associated with a greater risk and low returns. However, it is feasible to perform rescue ICSI for patients with IVF rates of <25%.

Targeting RING domains of Mdm2-MdmX E3 complex activates apoptotic arm of the p53 pathway in leukemia/lymphoma cells

Reactivation of tumor-suppressor p53 for targeted cancer therapy is an attractive strategy for cancers bearing wild-type (WT) p53. Targeting the Mdm2–p53 interface or MdmX ((MDM4), mouse double minute 4)–p53 interface or both has been a focus in the field. However, targeting the E3 ligase activity of Mdm2–MdmX really interesting new gene (RING)–RING interaction as a novel anticancer strategy has never been explored. In this report, we describe the identification and characterization of small molecule inhibitors targeting Mdm2–MdmX RING–RING interaction as a new class of E3 ligase inhibitors. With a fluorescence resonance energy transfer-based E3 activity assay in high-throughput screening of a chemical library, we identified inhibitors (designated as MMRis (Mdm2–MdmX RING domain inhibitors)) that specifically inhibit Mdm2–MdmX E3 ligase activity toward Mdm2 and p53 substrates. MMRi6 and its analog MMRi64 are capable of disrupting Mdm2–MdmX interactions in vitro and activating p53 in cells. In leukemia cells, MMRi64 potently induces downregulation of Mdm2 and MdmX. In contrast to Nutlin3a, MMRi64 only induces the expression of pro-apoptotic gene PUMA (p53 upregulated modulator of apoptosis) with minimal induction of growth-arresting gene p21. Consequently, MMRi64 selectively induces the apoptotic arm of the p53 pathway in leukemia/lymphoma cells. Owing to the distinct mechanisms of action of MMRi64 and Nutlin3a, their combination synergistically induces p53 and apoptosis. Taken together, this study reveals that Mdm2–MdmX has a critical role in apoptotic response of the p53 pathway and MMRi64 may serve as a new pharmacological tool for p53 studies and a platform for cancer drug development.

Comparison of charged nanoparticle concentrations near busy roads and overhead high-voltage power lines

Overhead high-voltage power lines are known sources of corona ions. These ions rapidly attach to aerosols to form charged particles in the environment. Although the effect of ions and charged particles on human health is largely unknown, much attention has focused on the increasing exposure as a result of the expanding power network in urban residential areas. However, it is not widely known that a large number of charged particles in urban environments originate from motor vehicle emissions. In this study, for the first time, we compare the concentrations of charged nanoparticles near busy roads and overhead power lines. We show that large concentrations of both positive and negative charged nanoparticles are present near busy roadways and that these concentrations commonly exceed those under high-voltage power lines. We estimate that the concentration of charged nanoparticles found near two freeways carrying around 120 vehicles per minute exceeded the corresponding maximum concentrations under two corona-emitting overhead power lines by as much as a factor of 5. The difference was most pronounced when a significant fraction of traffic consisted of heavy-duty diesel vehicles which typically have high particle and charge emission rates.

Trion-induced negative photoconductivity in monolayer MoS2

Optical excitation typically enhances electrical conduction and low-frequency radiation absorption in semiconductors. We, however, observe a pronounced transient decrease of conductivity in doped monolayer molybdenum disulfide (MoS(2)), a two-dimensional (2D) semiconductor, using ultrafast optical-pump terahertz-probe spectroscopy. In particular, the conductivity is reduced to only 30% of its equilibrium value at high pump fluence. This anomalous phenomenon arises from the strong many-body interactions in the 2D system, where photoexcited electron-hole pairs join the doping-induced charges to form trions, bound states of two electrons and one hole. The resultant increase of the carrier effective mass substantially diminishes the conductivity.

A review of phytotherapy of gout: perspective of new pharmacological treatments

The purpose of this review article is to outline plants currently used and those with high promise for the development of anti-gout products. All relevant literature databases were searched up to 25 March 2013. The search terms were 'gout', 'gouty arthritis', 'hyperuricemia', 'uric acid', 'xanthine oxidase (XO) inhibitor', 'uricosuric', 'urate transporter 1(URAT1)' and 'glucose transporter 9 (GLUT9)'. Herbal keywords included 'herbal medicine', 'medicinal plant', 'natural products', 'phytomedicine' and 'phytotherapy'. 'antiinflammatory effect' combined with the words 'interleukin-6 (IL-6)', 'interleukin-8 (IL-8)', 'interleukin-1beta (IL-1beta)', and 'tumor necrosis factor alpha (TNF-alpha)'. XO inhibitory effect, uricosuric action, and anti-inflammatory effects were the key outcomes. Numerous agents derived from plants have anti-gout potential. In in vitro studies, flavonoids, alkaloids, essential oils, phenolic compounds, tannins, iridoid glucosides, and coumarins show the potential of anti-gout effects by their XO inhibitory action, while lignans, triterpenoids and xanthophyll are acting through their anti-inflammatory effects. In animal studies, essential oils, lignans, and tannins show dual effects including reduction of uric acid generation and uricosuric action. Alkaloids reveal inhibit uric acid generation, show anti-inflammatory effects, or a combination of the two. Phenolic compounds and flavonoids inhibit uric acid production, show uricosuric anti-inflammatory effects. In the rare human studies, colchicine from Colchicum autumnale showed anti-inflammatory effects while for other plant extracts, although revealing anti-gout potential, further phytochemical investigations are needed to identify their active constituents. Besides, the plants which give antioxidant activities are much potent in the management of gout and need to be further investigated. The current review is a detailed discussion of the potential of medicinal plants for treatment of gout.

Protective effect of the nitric oxide pathway in L-citrulline renal ischaemia-reperfusion injury in rats

To observe the protective effects of L-citrulline on the renal I/R injury and elucidate the mechanisms involved, 48 rats were randomized into eight groups: Group 1: sham operated; Group 2: I/R (45 min renal ischaemia and 24 h reperfusion); Group 3: I/R + L-citrulline (300 mg/kg, i.g.); Group 4: I/R + L-citrulline (600 mg/kg, i.g.); Group 5: I/R + L-citrulline (900 mg/kg, i.g.); Group 6: I/R + normal saline (NS, i.g.); Group 7: I/R + N sup ω nitro-L-arginine ester (L-NAME, 20 mg/kg, i.p.); Group 8: I/R + L-citrulline (900 mg/kg, i.g.) + L-NAME (20 mg/ kg, i.p.). At the end of the reperfusion period, serum was collected and the kidneys underwent histological and biochemical examinations. Our results showed that pre-treatment with L-citrulline (300, 600, and 900 mg/kg) significantly ameliorated the renal injury caused by I/R. Moreover, L-citrulline prevented induction of lipid peroxidation and increased the activity of superoxide dismutase and the levels of glutathione and nitric oxide. The I/R-induced decreases in total nitric oxide synthase activity, inducible nitric oxide activity, constitutive nitric oxide activity and endothelial nitric oxide protein expression in the renal cortex were significantly prevented. However, the L-citrulline-mediated protection was significantly antagonized by co-administration of L-NAME. These results suggested that L-citrulline administration exhibited significant protection against renal I/R injury. This protective effect, at least in part, via up-regulation of the endothelial nitric oxide protein expression and constitutive nitric oxide synthase activity, maintained production of nitric oxide at the basal level.

Role of vegetation in enhancing radon concentration and ion production in the atmosphere

The role of ions in the production of atmospheric particles has gained wide interest due to their profound impact on climate. Away from anthropogenic sources, molecules are ionized by alpha radiation from radon exhaled from the ground and cosmic γ radiation from space. These molecular ions quickly form into "cluster ions", typically smaller than about 1.5 nm. Using our measurements and the published literature, we present evidence to show that cluster ion concentrations in forest areas are consistently higher than outside. Owing to the low range of alpha particles, radon present deep in the ground cannot directly contribute to the measured cluster ion concentrations. We propose an additional mechanism whereby radon, which is water-soluble, is brought up by trees and plants through the uptake of groundwater and released into the atmosphere by transpiration. We estimate that, in a forest comprising eucalyptus trees spaced 4 m apart, trees may account for up to 37% of the radon that is released from the ground during the middle of the day when transpiration rates are high. The corresponding percentage on an annual basis is 4.1%. Considering that 24% of the earth's land area is still covered in forests; these findings have potentially important implications for atmospheric aerosol formation and climate.

Detection of cervical metastatic lymph nodes in papillary thyroid carcinoma by Fourier transform infrared spectroscopy

Background

A previous study demonstrated that Fourier transform infrared (FTIR) spectroscopy can distinguish thyroid cancer from benign thyroid lesions. The aim of this study was to explore the use of FTIR for identifying metastatic lymph nodes of papillary thyroid cancer in vitro, and distinguishing between metastatic and non-metastatic tissue.

Methods

Some 184 freshly removed cervical lymph nodes were obtained from 22 patients with papillary thyroid cancer undergoing thyroid surgery with lymph node dissection. Samples were measured by FTIR spectroscopy before being processed for histopathological diagnosis. The FTIR spectrum of each sample identified 13 bands from 1000 to 4000 cm−1. The peak position, intensity and full width at half maximum of each absorbent band were measured, and the relative intensity ratios were calculated. The FTIR spectra of metastatic lymph nodes were compared with those of non-metastatic nodes, and a linear discriminant analysis was performed based on these data.

Results

Histopathological examination confirmed 61 metastatic and 123 non-metastatic lymph nodes. The FTIR parameters of metastatic and non-metastatic lymph nodes differed owing to the content or configuration alterations of nucleic acids, proteins, lipids and carbohydrates. The sensitivity for FTIR in diagnosing metastatic lymph nodes was 80·3 per cent, the specificity was 91·9 per cent and the accuracy was 88·0 per cent.

Conclusion

FTIR spectroscopy is a novel technique for detection of metastatic lymph nodes and may prove useful in surgery for papillary thyroid cancer.

Preliminary evaluation on the use of homing pigeons as a biomonitor in urban areas

This study evaluates the usefulness of homing pigeons as a biomonitor of polycyclic aromatic hydrocarbons (PAHs) in urban environments. The mean concentrations of total PAHs in liver and lung tissues were greater in pigeons from Beijing compared to pigeons from Chengdu, however, this difference was only statistically significant for PAH concentrations in liver tissue (P < 0.05). Similarly, the severity of anthracosis or pneumoconiosis in lung tissue and hepatitis in liver tissue was greater in pigeons from Beijing compared to pigeons from Chengdu. Low molecular weight PAHs dominated the contribution of individual PAHs in both tissues. Significant differences (P < 0.05) were observed for most low and moderate molecular weights PAHs in liver and for some low and high molecular weights PAHs in lung between the two cites. The profile patterns of individual PAHs were similar between lung tissue of pigeons and between local ambient airs in summer for both cities, whereas the profile patterns between liver tissue and pigeon food were less similar. These data suggest that homing pigeons may be of value as a biomonitor of environmental pollution in urban areas.