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Background: Microglial cultures comprise a critically important model system for investigating inflammatory mechanisms in almost all CNS disorders. Mild trypsinization and shaking are the two most commonly used methods to isolate primary microglia from mixed glial cultures. In this study, we characterized and compared microglia obtained using these two methods.Methods: Primary rat microglia cultures were prepared from cerebral cortices of 1-2-day-old neonatal Sprague-Dawley rats. After achieving confluency at about 14 days in vitro, microglia were isolated from mixed glial cultures via either mild trypsinization or shaking. The purity of microglia was estimated by flow cytometry. Quantitative real-time PCR was used to measure mRNA expression. TNFα, IL-1β, IL-10, and IGF-1 in cell culture supernatant were measured using ELISA kits. Phagocytic function was assessed using fluorescein-labeled Escherichia coli K-12 BioParticles.Results: Mild trypsinization generated a higher yield and purity than shaking. Microglia isolated by mild trypsinization appeared to be in a quiescent state with ramified morphology. Microglia isolated by shaking showed a more heterogenous morphology, including cells with rounded shapes suggestive of activation. Compared with shaking, microglia isolated by trypsinization also had lower baseline phenotype markers (iNOS, CD86, CD206, and arginase 1) and lower levels of cytokines (TNFα, IL-1β, IL-10, and IGF-1) as well as reduced phagocytic capability. Both methods yielded microglia that were responsive to various stimuli such as IL-4, lipopolysaccharide (LPS), or interferon-γ (IFNγ). Although stimulated patterns of gene expression and cytokine release were generally similar, there were also significant differences in terms of absolute response. LPS treatment induced significantly higher levels of TNFα and IL-10 in microglia isolated by mild trypsinization versus shaking. IFNγ induced a lower response in TNFα in microglia obtained by mild trypsinization versus shaking.Conclusions: Our results suggest that isolating microglia with the shaking method may induce slight activation even at baseline, and this may affect stimulus responses in subsequent experiments. Caution and attention should be warranted when choosing isolation protocols for primary microglia cultures. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study is to compare glenopolar angle (GPA) and the functional outcomes of fixation of both the clavicle and the scapular neck, fixation of the clavicle alone, and conservative treatment for floating-shoulder injuries. Methods A prospective stratified randomized study was performed in 39 adult patients who suffered floating-shoulder injuries and underwent fixation of both the clavicle and the scapular neck (group A), or fixation of the clavicle alone (group B), or conservative treatment (group C) between January 2005 and September 2011. The GPA, Disabilities of the Arm, Shoulder and Hand (DASH) score, and Constant-Murley Shoulder Outcome (Constant) score were compared between the three groups. Results All 39 patients were followed up for more than 2 years. GPA after bony consolidation was significantly better in group A than in groups B and C (p = 0.015). Functional outcomes measured by DASH and Constant scores were significantly better in group A at final follow- up (p = 0.008 and 0.002, respectively). Both DASH and Constant scores were highly correlated with GPA after consolidation (p < 0.001, respectively). The receiver operating characteristic (ROC) analysis showed that of the two randomly selected DASH scores, the smaller DASH score would have a larger GPA than the larger DASH score. Similarly, the larger Constant score would have a larger GPA than the smaller Constant score. Conclusions Fixation of both the clavicle and the scapular neck may correct GPA and improve functional outcomes for the treatment of floating-shoulder injuries. GPA after fracture consolidation is a useful prognostic indicator of a satisfactory clinical outcome as defined by either DASH score or Constant score. [ABSTRACT FROM AUTHOR]

Background: As inadequate pain communication contributes to difficulties in optimizing outcomes of outpatients, we investigated the effect of reinforced education using WeChat App to the opioid titration treatment of cancer-related pain in the outpatient setting.Methods: We conducted a prospective study to compare reinforced education using Wechat with care as usual from February to December 2019. Patients in the reinforced education group received reinforced education via Wechat, while those in the control group received care as usual. Effect measurements for both groups are carried out with questionnaires at the baseline and 3 days later. Questionnaires include pain intensity (NRS), treatment-related adverse events, cancer-related quality of life (QOL), sleep (PSQI), satisfaction, anxiety (GAD-7) and depression (PHQ-9). Number of patients whose NRS reduced to less than three points in 24 h was the primary outcomes. Secondary outcomes included treatment-related adverse events, cancer-related quality of life, sleep, satisfaction, anxiety and depression.Results: Although there was no significant difference regarding pain intensity (NRS) between the two groups at 72 h, the rate of NRS that reduced to less than three points in 24 h was significantly higher in the Wechat group than in the control group. Patients' satisfaction was significantly higher in the Wechat group than in the control group. There was no significant difference between the two groups regarding the other findings at 72 h, including pain intensity (NRS), cancer-related quality of life (QOL), anxiety (GAD-7), depression (PHQ-9), and sleep (PSQI). However, no significant difference was found between the two groups for constipation, nausea, vomiting, dizziness, somnolence, pruritus, loss of consciousness, and death.Conclusions: Our results indicated that receiving instructions delivered by Wechat resulted an increased number of patients with good pain control and better satisfaction. The study provided insight into the effectiveness of the reinforced education using a Wechat app delivered by a doctor to outpatients in the titration treatment of cancer-related pain.Trial Registration: This study was registered at chictr.org (Registration number: ChiCTR1900021150 , Date of Registration: January 30, 2019). [ABSTRACT FROM AUTHOR]

Introduction: In recent years, a growing number of researchers have begun to study fertility awareness (FA). Evidence suggests that college students in their reproductive years have a common understanding of fertility, risk factors for infertility, and assisted reproductive technologies. Therefore, this systematic review summarizes these studies and explores the factors affecting college students' fertility awareness. Methods: A systematic literature search of databases (PUBMED/MEDLINE, Cochrane, Web of Science, Embase, and EBSCO) was conducted from inception to September 2022. Studies that assessed the levels of fertility awareness and factors influencing college students were considered for the review. The qualities of the included studies were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. This systematic review is reported according to the preferred reporting items for systematic review (PRISMA) guidelines. Results: Twenty-one articles met the eligibility criteria and were included. The preliminary results showed that participants reported low to moderate FA. Female medical students demonstrated higher levels of fertility awareness. The association between age, years of education, and FA was insufficient. Conclusion: The results of the current study suggest that increased FA interventions are warranted, especially for the male, non-medical student population. Governments and educational institutions should strengthen education programs for young students on reproductive health to help them raise awareness about childbirth, and society should provide family support for young people. [ABSTRACT FROM AUTHOR]

Background: Neuroinflammation is one of the most important processes in secondary injury after traumatic brain injury (TBI). Triggering receptor expressed on myeloid cells 2 (TREM2) has been proven to exert neuroprotective effects in neurodegenerative diseases and stroke by modulating neuroinflammation, and promoting phagocytosis and cell survival. However, the role of TREM2 in TBI has not yet been elucidated. In this study, we are the first to use COG1410, an agonist of TREM2, to assess the effects of TREM2 activation in a murine TBI model.Methods: Adult male wild-type (WT) C57BL/6 mice and adult male TREM2 KO mice were subjected to different treatments. TBI was established by the controlled cortical impact (CCI) method. COG1410 was delivered 1 h after CCI via tail vein injection. Western blot analysis, immunofluorescence, laser speckle contrast imaging (LSCI), neurological behaviour tests, brain electrophysiological monitoring, Evans blue assays, magnetic resonance imaging (MRI), and brain water content measurement were performed in this study.Results: The expression of endogenous TREM2 peaked at 3 d after CCI, and it was mainly expressed on microglia and neurons. We found that COG1410 improved neurological functions within 3 d, as well as neurological functions and brain electrophysiological activity at 2 weeks after CCI. COG1410 exerted neuroprotective effects by inhibiting neutrophil infiltration and microglial activation, and suppressing neuroinflammation after CCI. In addition, COG1410 treatment alleviated blood brain barrier (BBB) disruption and brain oedema; furthermore, COG1410 promoted cerebral blood flow (CBF) recovery at traumatic injury sites after CCI. In addition, COG1410 suppressed neural apoptosis at 3 d after CCI. TREM2 activation upregulated p-Akt, p-CREB, BDNF, and Bcl-2 and suppressed TNF-α, IL-1β, Bax, and cleaved caspase-3 at 3 d after CCI. Moreover, TREM2 knockout abolished the effects of COG1410 on vascular phenotypes and microglial states. Finally, the neuroprotective effects of COG1410 were suppressed by TREM2 depletion.Conclusions: Altogether, we are the first to demonstrate that TREM2 activation by COG1410 alleviated neural damage through activation of Akt/CREB/BDNF signalling axis in microglia after CCI. Finally, COG1410 treatment improved neurological behaviour and brain electrophysiological activity after CCI. [ABSTRACT FROM AUTHOR]

Background: MICAL1 is involved in the malignant processes of several types of cancer; however, the role of MICAL1 in pancreatic cancer (PC) has not been well-characterized. This study aimed to investigate the expression and function of MICAL1 in PC.Methods: RT-qPCR and immunohistochemistry were used to detect MICAL1 expression in PC and adjacent nontumor tissues. Cell Counting Kit-8, EdU, clone formation, wound healing, and Transwell assays as well as animal models were used to investigate the effects of overexpression or inhibition of MICAL1 expression on the proliferation, invasion, and metastasis of PC cells. RNA-seq was used to explore the main pathway underlying the functions of MICAL1. Proteomics, mass spectrometry, and co-immunoprecipitation assays were used to investigate the interaction of proteins with MICAL1. Rescue experiments were conducted to validate these findings.Results: Both MICAL1 mRNA and protein levels were upregulated in PC tissues compared with matched adjacent nontumor tissues. The expression level of MICAL1 was associated with the proliferative and metastatic status of PC. Repression of MICAL1 significantly inhibited PC cell growth, migration, and invasion in vitro and in vivo. RNA sequencing analysis indicated that MICAL1 was closely correlated with the WNT pathway. Overexpression of MICAL1 (1) promoted the phosphorylation of TBC1D1 at the Ser660 site, (2) facilitated the distribution of FZD7 on the cytomembrane, (3) inhibited the degradation of FZD7 in the lysosome, and (4) activated the WNT pathway.Conclusions: MICAL1 was upregulated in PC and involved in stimulating the progression of PC cells by activating the WNT/β-catenin signaling pathway. Therefore, MICAL1 is a potential therapeutic target for PC. [ABSTRACT FROM AUTHOR]

Background: Treatment of chronic myeloid leukemia with a tyrosine kinase inhibitor (TKI) offers significant improvements over previous treatments in terms of survival and toxicity yet nevertheless is associated with reduced health-related quality of life and very high cost. Several small studies from Europe and Australia suggested that discontinuing TKIs with regular monitoring was safe.Methods: The Life After Stopping TKIs (LAST) study is a large, U.S.-based study that aims to improve the evidence for clinical decision making regarding TKI discontinuation with monitoring in patients with chronic myeloid leukemia who have a deep molecular response to TKI therapy. The LAST study is a non-randomized, prospective, single-group longitudinal study of 173 patients. The co-primary objectives are to determine the proportion of patients who develop molecular recurrence (> 0.1% BCR-ABLIS) after discontinuing one of four TKIs (imatinib, dasatinib, nilotinib, or bosutinib) and to compare the patient-reported health status of patients before and after stopping TKIs. Outcomes are assessed at baseline and throughout the 36-month study follow-up period with a central laboratory used for blood samples. All samples with undetectable BCR-ABL are also examined using digital polymerase chain reaction, which is a more sensitive nanofluidic polymerase chain reaction system.Discussion: Because of their high cost and side effects, discontinuation of TKIs for patients with chronic myeloid leukemia who have a deep molecular response to TKI therapy is a promising approach to treatment. The LAST study is the largest U.S.-based TKI discontinuation study. It is the first to allow participation from patients on any of 4 first- and second-generation TKIs, includes a robust approach to measurement of clinical and patient-reported outcomes, and is using digital polymerase chain reaction to explore better prediction of safe discontinuation.Trial Registration: This study was registered prospectively on October 21, 2014 and assigned trial number NCT02269267 . [ABSTRACT FROM AUTHOR]

Background: Lăo huŏ liàng tāng (Cantonese slow-cooked soup, CSCS) is popular in Guangdong, China, and is consumed by Cantonese people worldwide as a delicious appetizer. Because CSCS serves as an important part of family healthcare, medicinal plants and plant-derived products are major components of CSCS. However, a collated record of the diverse plant species and an ethnobotanical investigation of CSCS is lacking. Because of globalization along with a renewed interest in botanical and food therapy, CSCS has attracted a growing attention in soup by industries, scientists, and consumers. This study represents the first attempt to document the plant species used for CSCS in Guangdong, China, and the associated ethnomedical function of plants, including their local names, part(s) used, flavors, nature, preparation before cooking, habitats, and conservation status. Methods: In 2014-2017, participatory approaches, open-ended conversations, and semi-structured interviews were conducted with 63 local people and 48 soup restaurant owners (111 interviews) to better understand the biocultural context of CSCS, emphasizing ethnobotanical uses of plants in Guangdong Province, China. Product samples and voucher specimens were collected for taxonomic identification. Mention Index (QI), frequency of use index (FUI), and economic index (EI) were adopted to evaluate the significance of each plant in the food supply. Results: A total of 97 plant species belonging to 46 families and 90 genera were recorded as having been used in CSCS in the study area. Recorded menus consisted of one or several plant species, with each one used for different purposes. They were classified into 11 functions, with clearing heat being the most common medicinal function. Of the 97 species, 19 grew only in the wild, 8 species were both wild and cultivated, and 70 species were cultivated. Roots and fruits were the most commonly used plant parts in the preparation of CSCS. According to the national evaluation criteria, six of these species are listed on "China's red list" including two endangered, two critically endangered, one near-threatened, and one vulnerable species. The QI, FUI, and EI of the 97 species in the study varied between 0.09 and 1, 0.23 and 9.95, and 0.45 and 6.58, respectively. Conclusions: As an important part of Cantonese culture, CSCS has been popularized as a local cuisine with a healthcare function. CSCS also reflects the plant species richness and cultural diversity of Guangdong Province. Future research on the safety and efficacy of CSCS as well as on ecological and cultural conservation efforts is needed for the sustainable growth of China's botanical and medicinal plant industry. [ABSTRACT FROM AUTHOR]

Background: Mucopolysaccharidosis type II (MPS II) is an X-linked recessive, multisystemic lysosomal storage disorder caused by a deficiency of iduronate-2-sulfatase. MPS II has a variable age of onset and variable rate of progression. In Asian countries, there is a relatively higher incidence of MPS II compared to other types of MPS.Methods: A retrospective analysis was carried out of 34 Taiwanese MPS II patients who died between 1995 and 2012. The clinical characteristics, medical records, age at death, and cause of death were evaluated to better understand the natural progression of this disease.Results: The mean age at death of 31 of the patients with a severe form of the disease with significant cognitive impairment was 13.2 ± 3.2 years, compared with 22.6 ± 4.3 years in the three patients with a mild form of the disease without cognitive involvement (n = 2) or the intermediate form (n = 1) (p < 0.001). The mean ages at onset of symptoms and confirmed diagnosis were 2.5 ± 2.1 and 4.8 ± 3.1 years, respectively (n = 32). Respiratory failure was the leading cause of death (56 %), followed by cardiac failure (18 %), post-traumatic organ failure (3 %), and infection (sepsis) (3 %) (n = 27). Age at onset of symptoms was positively correlated with life expectancy (p < 0.01). Longevity gradually increased over time from 1995 to 2012 (p < 0.05).Conclusions: Respiratory failure and cardiac failure were the two major causes of death in these patients. The life expectancy of Taiwanese MPS II patients has improved in recent decade. [ABSTRACT FROM AUTHOR]

Background: The choice of primary hip hemiarthroplasty or total hip arthroplasty for displaced femoral neck fracture is still controversial. Revision hip arthroplasty not only increases risk and cost but also could result in worse outcome. Determining the risk factors for revision can help inform medical decision-making and aid in risk stratification of publicly reported outcomes. Therefore, we conducted a nationwide population-based study to identify the disease-related risk factors and construct a risk score nomogram to predict revision surgery. Methods: Records of all 68,030 femoral neck fracture patients receiving partial hemiarthroplasty (HA) in 2000-2010, with no total hip arthroplasty (THA) or revision HA history, were collected from the National Health Insurance Research Database. Cox proportional hazard regression was used to estimate the risk of revision hip replacement (RHA). The score of each risk factor was the quotient of the regression coefficient of the variable by the regression coefficient for a 10-year increase in age. The predictive accuracy was tested using the area under the receiver operating characteristic curve (AUROC). Results: The revision risk for hemiarthroplasty increased in male, those with schizophrenia and end-stage renal disease patients had 1.58-, 1.88-, and 1.74-fold revision HA risk (95 % confidence interval (CI) = 1.40-1.78,1.26-2.79, and 1.29-2. 34, respectively). In a predictive model, the cumulative risk score ranged from 0 to 13 with a 5.08 to 91.82 % 10-year predicted RHA risk. The percentage of AUROC for 10-year RHA risk in nomogram was 61.9 (95 % CI = 60.0-63.4). Conclusions: Males, schizophrenia and end-stage renal disease patients have higher risk of revision surgery after hemiarthroplasty for femoral neck fracture. [ABSTRACT FROM AUTHOR]

Background: Retractor placement is a leading cause of intraoperative nerve injury during total hip replacement (THR) surgery. The sciatic nerve, femoral nerve, and superior gluteal nerve are most commonly affected. This study aimed to identify the distances from bony landmarks in the hip to the adjacent nerves on magnetic resonance imaging (MRI) and the associations between anatomical factors and these distances that would guide the placement of retractors during THR surgery, in order to minimize the risk of nerve injury. Methods: We reviewed hip MRIs of 263 adults and recorded the distances from (1) the anterior acetabular rim to the femoral nerve; (2) the superior acetabular rim to the superior gluteal nerve; (3) the posterior acetabular rim to the sciatic nerve; and (4) the greater trochanter to the sciatic nerve. The effects of anatomical factors (i.e., gender, age, body height, body mass index (BMI), pelvic width, and acetabular version and morphology) on these distances were analyzed. Results: Distances from bony landmarks to adjacent nerves (in cm) were 2.06 ± 0.44, 2.23 ± 0.28, 1.94 ± 0.81, and 4.83 ± 0.26 for the anterior acetabular rim, superior acetabular rim, posterior acetabular rim, and greater trochanter, respectively, and were shorter in women than in men (P< 0.001). Multivariate analysis identified body height as the most influential factor (P< 0.001). Linear regression demonstrated a strong positive linear correlation between body height and these distances (Pearson's r= 0.808, 0.823, 0.818, and 0.792, respectively (P < 0.001)). Conclusions: The distances from bony landmarks to adjacent nerves provide useful information for placing retractors without causing nerve injury during THR surgery. Shorter patients will have shorter distances from bony landmarks to adjacent nerves, prompting more careful placement of retractors. [ABSTRACT FROM AUTHOR]