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Objective To analyze the duration of gonadotropin hyperstimulation's impacts on oocyte quality and clinical outcomes in aged in vitro fertilization (IVF) patients. Materials and methods This retrospective study was carried out using IVF records of the Chang Gung Memorial Hospital IVF center from January 2017 to December 2019. A total of 308 IVF cycles with patients aged 40–44 years were included. Clinical characteristics of patients who received a short controlled ovarian hyperstimulation (COH) (i.e., 6–7 days; s-COH group) or a long COH treatment (i.e., 9–10 days; l-COH group) were compared. In addition, analysis was conducted using data within two age subgroups: 40–42 years and 42–44 years subgroups. Results The s-COH group received significantly lower total doses of gonadotropin and had smaller leading follicles at the time of ovulation trigger when compared to the l-COH group. The s-COH group also produced a significantly lower number of oocytes, mature metaphase II (MII) oocytes, and 2 PN zygotes compared to the l-COH group. However, there was no significant difference in the number of transferable and good-quality embryos between the two treatment groups. Likewise, the pregnancy rate and live birth rate were comparable in the s-COH and l-COH groups. Similar results were obtained when the analysis was limited to select age subgroups (i.e., 40–42 and 42–44 years subgroups). Conclusion While a long COH generates more oocytes per cycle, a 6–7 days COH treatment, which is at the lower end of the recommended window of stimulation, could achieve a pregnancy outcome comparable to that applied 9–10 days of COH in aged patients.

Objective: Cox Maze procedure is an effective surgical treatment of atrial fibrillation and it is often performed concomitantly with mitral valve surgery. However, some patients still experience atrial tachyarrhythmia post-surgery, which adversely affects heart function as well as their quality of life. Method: We present the case of a 66-year-old female patient who underwent mitral valve replacement with a bio-prosthesis and Cox-Maze procedure; she was later admitted to our center after 14 months due to pneumonia and atrial tachycardia. An electrophysiology study/ intervention was performed. Result: We successfully determined the mechanism and ablated the atrial tachyarrhythmia. The sinus rhythm was restored and was maintained 3 months post-procedure, with amelioration of the left ventricular function. Conclusion: Electrophysiology study with electro-anatomy mapping can help to determine the mechanism of arrhythmia to guide successful ablation of post-operative arrhythmia

Objective: With the scenario of limited labeled dataset, this paper introduces a deep learning-based approach that leverages Diabetic Retinopathy (DR) severity recognition performance using fundus images combined with wide-field swept-source optical coherence tomography angiography (SS-OCTA). Methods: The proposed architecture comprises a backbone convolutional network associated with a Twofold Feature Augmentation mechanism, namely TFA-Net. The former includes multiple convolution blocks extracting representational features at various scales. The latter is constructed in a two-stage manner, i.e., the utilization of weight-sharing convolution kernels and the deployment of a Reverse Cross-Attention (RCA) stream. Results: The proposed model achieves a Quadratic Weighted Kappa rate of 90.2% on the small-sized internal KHUMC dataset. The robustness of the RCA stream is also evaluated by the single-modal Messidor dataset, of which the obtained mean Accuracy (94.8%) and Area Under Receiver Operating Characteristic (99.4%) outperform those of the state-of-the-arts significantly. Conclusion: Utilizing a network strongly regularized at feature space to learn the amalgamation of different modalities is of proven effectiveness. Thanks to the widespread availability of multi-modal retinal imaging for each diabetes patient nowadays, such approach can reduce the heavy reliance on large quantity of labeled visual data. Significance: Our TFA-Net is able to coordinate hybrid information of fundus photos and wide-field SS-OCTA for exhaustively exploiting DR-oriented biomarkers. Moreover, the embedded feature-wise augmentation scheme can enrich generalization ability efficiently despite learning from small-scale labeled data.

Nam Nguyen Van,1 Pham Ngoc Hung,2,3 Le Tien Dung,4 Le Viet Anh,1 Dinh Cong Pho,5 Bui Dang The Anh,2 Vu Anh Hai1 1Department of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Training, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Thoracic Surgery, Phạm Ngọc Thạch Hospital, Ho Chi Minh City, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Vu Anh HaiDepartment of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Ha Dong District, Hanoi, VietnamTel +84986112345Email vuanhhai.ncs@gmail.comBackground: Mid-term outcomes of video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) in Vietnam should be evaluated and discussed.Methods: This prospective descriptive study was conducted on 94 patients with NSCLC under stages I–IIA who were treated with VATS from November 2011 to July 2014.Results: The median patient age was 55.5 ± 10.8 years. The rate of successful VATS for NSCLC treatment was 98.9%, and the conversion rate (from VATS to thoracotomy) was 1.1%. The operative time was 143.8 ± 38.9 minutes, the amount of blood loss was 194.8 ± 150.5 mL, and the postoperative complication rate was 10.6%. The ICU length stay was 2.8 ± 1.0 days, and the postoperative hospital length stay was 7.7 ± 2.1 days. Among the 89 patients with successful follow-up, one (1.1%) had a recurrent tumor, and ten (11.8%) had metastasis. The 1- and 2-year relative survival rates were 95.9% (3 deaths) and 80.8% (9 deaths), respectively.Conclusion: VATS treatment for early stage NSCLC is an effective method with safe outcomes. The mid-term outcomes were acceptable with 1- and 2-year relative survival rates of 95.9% and 80.8%, respectively.Keywords: video-assisted thoracoscopic surgery, VATS, non-small cell lung cancer, NSCLC, early-stage, short-term outcomes, mid-term outcomes

Objectives: To evaluate plombage surgery for hemoptysis control in pulmonary aspergilloma in high-risk patients. Methods: This study was carried out on 75 pulmonary aspergilloma patients presenting with hemoptysis that underwent a plombage surgery for approximately 7 years (November 2011–September 2018) at Pham Ngoc Thach Hospital. They revisited the hospital 6 months after plombage surgery and considered plombage removal. The group whose plombage was removed was compared with that whose plombage was retained 6 and 24 months after surgery. Results: Hemoptysis reduced significantly after surgery. Hemoptysis ceased in 91.67% of the patients and diminished in 8.33% of the patients 6 months after surgery. Similarly, hemoptysis ceased in 87.32% of the patients and diminished in 12.68% of the patients 24 months after surgery. Body mass index (BMI) index, Karnofsky score, and forced expiratory volume in one second (FEV1) increased. Plombage surgery was performed with operative time of 129.5 ± 36.6 min, blood loss during operation of 250.7 ± 163.1 mL, and the number of table tennis balls of 4.22 ± 2.02. No deaths related to plombage surgery were recorded. Plombage was removed in 29 cases because of patients’ requirements (89.8%), infection (6.8%), and pain (3.4%). There were no patient developing complications after the treatment and there were no statistically significant differences between the two groups. Conclusions: Plombage surgery is safe and effective for hemoptysis control in pulmonary aspergilloma. To minimize the risk of long-term complications, surgeons should remove the plombage 6 months after the initial operation.

Rullia tuberosa L. is used for treatment of diabetes mellitus, anti-inflammation, etc. However, its hypoglycaemic and anti inflammatory activities has not been investigated so far. In the present study, the α-glucosidase inhibitory, anti inflammatory activities of the extract of this plant were investigated. Our results showed that the crude extract as well as ethyl acetate and methanol fractions showed α-glucosidase inhibitory activity with IC50 of 15.84, 4.73 and 8.27 µg/ml, respectively. In addition, the hexane and ethyl acetate fractions are capable of inhibiting LPS-induced NO production with IC50 of 17.41 and 23.95 µg/mL, respectively. From the ethyl acetate and methanol fractions, eight compounds, including isobargaptol 5-O-β-D-glucopyranoside (1), syringaresinol (2), catechin (3), pulmatin (4), stigmast-4-en-3-on (4), verbascoside (5), hydroxymethylfurfural (6), rutin (7), and homoplantaginin (8) were extracted and isolated. Their chemical structures were elucidated by spectroscopic method including MS, 1 D and 2 D- NMR and comparison with the literature values.

Background: This study aimed to quantify the proportion of participants with chronic kidney disease (CKD) and associated metabolic risk factors in a middle-aged and elderly population in Guishan District, Taoyuan City, Taiwan.Methods: This cross-sectional study enrolled residents aged 50–90 years living in one community. All participants received a standardized personal interview, including a structured questionnaire, anthropometric measurements, and blood samples collected for laboratory testing. CKD was defined as the presence of kidney damage (urine albumin-creatinine ratio ≥30 mg/g) or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Multiple logistic regression models were used to evaluate the risk factors associated with CKD.Results: A total of 400 participants were enrolled. The overall proportion of participants with CKD was 20.5% (95% confidence interval [CI]: 16.54–24.46%). The proportions of participants with CKD among those aged 50–64, 65–74, and 75 years and over were 17.7, 18.8, and 35.7%, respectively (p = 0.01). Multiple logistic regression model revealed that elevated blood pressure (odds ratio [OR] = 2.23, 95% CI: 1.16–4.30), hyperglycemia (OR = 2.87, 95% CI: 1.64–5.00), hyperuricemia (OR = 1.38, 95% CI: 1.14–1.69), and metabolic syndrome (OR = 2.30, 95% CI: 1.31–4.06) were significantly associated with CKD.Conclusions: The prevalence of CKD in the study population was high. Hypertension, hyperglycemia, hyperuricemia, and metabolic syndrome are significantly associated with CKD in a middle-aged and elderly population in Taiwan.

External nutrient loadings to Lake Biwa were estimated using a combined tank model and loading-discharge curve approach. The model was applied to collective drainage basins of the lake’s Imazu (northwest), Hikone (northeast), and Otsu (south) areas. The hourly model was conducted using particular discharges from Kita (Ado) river, Takatoki (Ane) river, and Yasu River to obtain loading curves for phosphate (PO4) and silica (SiO2) by assimilating measured concentrations (2002–2003). The tank model was updated by adding an evapotranspiration routine and direct paths of groundwater discharges to the lake floor. The daily model was calibrated through analysis of water budget among the basin, inflow, lake and outflow, and then validated. The model was established and combined into a loading-discharge curve to determine the long-term external nutrient loadings entering the lake (1980–2017). Seasonal variation in nutrient loadings increased during spring and summer and decreased during winter. Annual phosphate-phosphorus (PO4-P) loading ranged from 217 to 296 tons yr–1 in the North Basin and 45 to 76 tons yr–1 in the South Basin, while SiO2 loading fluctuated from 16,027 to 32,655 tons yr–1 and 2,518 to 5,490 tons yr–1 in the North and South Basins, respectively.

Background In high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed. This study aimed to evaluate this surgery compared two compressing materials. Methods A total of 63 in high-risk patients who suffered from hemoptysis due to complex pulmonary aspergilloma and underwent cavernostomy and thoracoplasty surgery from November 2011 to September 2018 at Pham Ngoc Thach hospital were evaluated prospectively studied. Patients were allocated to two groups: the table tennis ball group and tissue expander group. We evaluated at the time of before operation, 6 months and 24 months after operation. Results Tuberculosis was the most common comorbidity diseases in both groups. Upper lobe occupied almost in location. Hemoptysis symptoms plunged from time to time. Statistically significant Karnofsky score was observed in both groups. Postoperative pulmonary functions (FVC and FEV1) have remained in both groups at all time points. The remarkable results were no deaths related to surgery and low complications both short and long-term. There was no statistical significance between two groups in operative time, blood loss during operation, ICU length-stay time. Four patients died because of co-morbidity in 24 months follow-up. Conclusion Cavernostomy and thoracoplasty was safe and effective surgery for the treatment of complex pulmonary aspergilloma with hemoptysis in high-risk patients. No mortality related to surgery and low complications were recorded. The was no inferiority when compared two compressing materials .

In Vietnam, the medicinal plant Scoparia dulcis is used for the treatment of bronchitis, gastric disorders, antidiabetes, hypertension, hepatitis etc. In this paper, experiments was designed to evaluate in vitro anticancer and anti-inflammatory activities and isolate phytochemicals from methanol extracts of Scoparia dulcis whole plants. The chemical investigation of methanol fraction of Scoparia dulcis led to the isolation of benzoxazinone (1), phenylethanoid (2), flavone (3), and lignan (4) glycosides. The bioactivity results indicated that crude ethanol and ethyl acetate extracts had potent cytotoxic activity toward the HepG2 cancer cell with IC50 of 47.03 μg/mL and 36.04 μg/mL, respectively. Interestingly, crude ethanol and ethyl acetate extracts had the NO inhibitory activity, with inhibition of 56.9 % or 74.7 % at 30 μg/mL and 97.3% or 82.9 % at 100 μg/mL, respectively. In addition, the hexane extract at concentrations of 100 μg/ml demonstrated anti-inflammatory activity through the inhibition of nitric oxide production of 76.7%.

Background Video-assisted thoracoscopic surgery lobectomy combined with lymphadenectomy is widely utilized worldwide for treating non-small cell lung cancer. We evaluated the long-term survival outcomes of this approach and determined the prognostic factors of overall survival. Methods This prospective observational study was performed in patients with non-small cell lung cancer who were subjected to video-assisted lobectomy and lymphadenectomy from 2012 to 2016. Independent prognostic factors were determined via uni- and multivariable Cox models. Results There were 109 patients with the mean age of 59.2 years and males accounted for 54.1%. Postoperative staging determined 22.9% of stage IA, 31.2% of stage IB, 16.5% of stage IIA and 29.4% of stage IIIA. Median follow-up time was 27 months. The overall survival rate after 1, 2, 3, 4 and 5 years was 100%, 85.9%, 65.3%, 55.9% and 55.9%, respectively. In univariable analysis, smoking (hazard ratio (HR) [95% confidence interval (CI)]: 2.50 [1.18–5.31]), Tumor--nodes--metastases (TNM) stage (IIA: 7.60 [1.57–36.9]; IIIA: 14.3 [3.28–62.7] compared to IA), histological differentiation (moderately differentiated: 4.91 [1.04–23.2]; poorly differentiated: 8.25 [1.91–35.6] compared to well differentiated), lymph node size ≥1 cm (8.22 [3.11–21.7]), tumour size ≥3 cm (4.24 [1.01–17.9]), radical lymphadenectomy (6.67 [3.14–14.2]) were identified as prognostic factors of the long-term survival. In multivariable analysis, only radical lymphadenectomy was an independent prognostic factor (HR [95% CI]: 3.94 [1.41–11.0]). Conclusion Video-assisted thoracoscopic lobectomy combined with lymphadenectomy is feasible, safe and effective for the treatment of non-small cell lung cancer. The long-term outcomes of this method are favourable, especially at the early stage of cancer.

Scar formation can cause the failure of glaucoma filtration surgery. We investigated the effect of AR12286, a selective Rho-associated kinase inhibitor, on myofibroblast transdifferentiation and intraocular pressure assessment in rabbit glaucoma filtration surgery models. Cell migration and collagen contraction were used to demonstrate the functionality of AR12286-modulated human conjunctival fibroblasts (HConFs). Polymerase chain reaction quantitative analysis was used to determine the effect of AR12286 on the production of collagen Type 1A1 and fibronectin 1. Cell migration and collagen contraction in HConFs were activated by TGF-&beta, 1. However, compared with the control group, rabbit models treated with AR12286 exhibited higher reduction in intraocular pressure after filtration surgery, and decreased collagen levels at the wound site in vivo. Therefore, increased &alpha, SMA expression in HConFs induced by TGF-&beta, 1 could be inhibited by AR12286, and the production of Type 1A1 collagen and fibronectin 1 in TGF-&beta, 1-treated HConFs was inhibited by AR12286. Overall, the stimulation of HConFs by TGF-&beta, 1 was alleviated by AR12286, and this effect was mediated by the downregulation of TGF-&beta, receptor-related SMAD signaling pathways. In vivo results indicated that AR12286 thus improves the outcome of filtration surgery as a result of its antifibrotic action in the bleb tissue because AR12286 inhibited the TGF-&beta, receptor-related signaling pathway, suppressing several downstream reactions in myofibroblast transdifferentiation.

Caryota mitis L., a flowering plant, belongs to the family Arecaceae. In Vietnam, its fruits were used to treat joint pain. The present study was designed to investigate the phytochemicals and chondrocyte proliferation activity of C. mitis L. fruits on young human chondrocyte. The results showed that all of extracts (crude extract as well as n-hexane, chloroform, ethyl acetate and methanol fractions) were stimulated the growth of chondrocyte at 0.1 μg/mL; 0.01 μg/mL concentrations, of which the n-hexane and methanol fractions significantly increased the proliferation of chondrocyte by 30.75 and 24.42% at concentrations of 0.01 μg/mL, respectively. Repeated chromatography of the methanol fraction on silica gel, Sephadex LH-20 and ODS columns afforded a new cerebroside and eight known ones. Their structures were elucidated by analysis of spectral data and in comparison with the published reports.

Background Diabetic Retinopathy (DR) is considered a pathology of retinal vascular complications, which stays in the top causes of vision impairment and blindness. Therefore, precisely inspecting its progression enables the ophthalmologists to set up appropriate next-visit schedule and cost-effective treatment plans. In the literature, existing work only makes use of numerical attributes in Electronic Medical Records (EMR) for acquiring such kind of DR-oriented knowledge through conventional machine learning techniques, which require an exhaustive job of engineering most impactful risk factors. Objective In this paper, an approach of deep bimodal learning is introduced to leverage the performance of DR risk progression identification. Methods In particular, we further involve valuable clinical information of fundus photography in addition to the aforementioned systemic attributes. Accordingly, a Trilogy of Skip-connection Deep Networks, namely Tri-SDN, is proposed to exhaustively exploit underlying relationships between the baseline and follow-up information of the fundus images and EMR-based attributes. Besides that, we adopt Skip-Connection Blocks as basis components of the Tri-SDN for making the end-to-end flow of signals more efficient during feedforward and backpropagation processes. Results Through a 10-fold cross validation strategy on a private dataset of 96 diabetic mellitus patients, the proposed method attains superior performance over the conventional EMR-modality learning approach in terms of Accuracy (90.6%), Sensitivity (96.5%), Precision (88.7%), Specificity (82.1%), and Area Under Receiver Operating Characteristics (88.8%). Conclusions The experimental results show that the proposed Tri-SDN can combine features of different modalities (i.e., fundus images and EMR-based numerical risk factors) smoothly and effectively during training and testing processes, respectively. As a consequence, with impressive performance of DR risk progression recognition, the proposed approach is able to help the ophthalmologists properly decide follow-up schedule and subsequent treatment plans.

Young women with endometrial cancer (EC) can choose fertility-sparing treatment for stage 1A disease without myometrial invasion (MI). The surgical diagnostic procedure (SDP) may affect the accuracy of magnetic resonance imaging (MRI) to assess MI. Here, we evaluated different SDP and compared the MI on MRI results with further pathologic results after hysterectomy. We retrospectively collected data on 263 patients with clinical stage IA EC diagnosed between January 2013 and December 2015. Patients were classified into four groups based on SDP, including diagnostic hysteroscopic biopsy (DHB, group 1), operative hysteroscopic partial resection (OHPR, group 2), operative hysteroscopic complete resection (OHCR, group 3), and cervical dilatation and fractional curettage (D&amp, C, group 4). The sensitivity, specificity, diagnostic accuracy, positive predictive value, and negative predictive value of MRI to assess MI were 73.1%, 46.7%, 63.9%, 71.8%, and 48.3%, respectively. Three hysteroscopic procedures (groups 1 to 3) had a trend with a higher odds ratio of discrepancy between MRI and histopathology (p = 0.068), especially in group 2 (odds ratio 2.268, p = 0.032). Here, we found MRI accuracy of MI was better in patients with EC diagnosed with D&amp, C. Three diagnostic procedures using hysteroscopy might interfere with the diagnostic power of MI on MRI.

Cassia grandis is used for the treatment of skin disorders, back pain, aches, etc. in Vietnamese traditional medicine. In this paper, phytochemicals of the leaves were investigated. A new naphthalene derivative (1, cassgranon D) and, seven known compounds rutin (2), afzelin (3), quercitrin (4), epicatechin (5), (-)-epiafzelechin (6), isoquercitrin (7) and aloe emodin (8) were isolated from the ethyl acetate and methanol extracts. Their structures were elucidated by spectral evidences (UV, IR, MS, 1H, 13C, DEPT, HSQC and HMBC NMR), as well as by comparing with published data.

In this paper, we propose a combined solution to collect and detect both the heart rate and the obstruction sleep apnea using only vibration signals measured at the patient’s neck. Our proposed wearable device can capture vibration signals caused by the respiratory activities and the blood flows in the common carotid artery (CCA) and the internal jugular vein (IJV) on the patient’s neck area during sleeping. The data are sent to a server via WIFI connection and stored in a database for further analysis. Our system is accurate and low-cost for capturing the signals and monitoring many patients simultaneously. Moreover, the paper approach also goes deeper into signal processing by using a combination of the Savitzky-Golay filter, a lowpass filter, peak detecting and clustering techniques to extract the heart rate from the vibration of the carotid artery and the jugular. We also propose an algorithm for detecting the apnea state of a monitored patient using the bispectral analysis. In our initial experiments, the proposed algorithms obtain positive achievements.

Ten compounds (1–10) were purified from the extract of lichens C. faveomaculata, and among these one new triterpenoid, cryptothecin A (1) was characterized through mass spectrometric and 2D NMR spectroscopic analyses. Some of the isolated compounds were assessed for their antimicrobial (1, 6, and 8) and cytotoxic activity (1, 4–5, and 7–9), but only weak inhibitory effects were observed.

Ischemia-reperfusion (I/R) injury is associated with numerous retinal diseases, such as diabetic retinopathy, acute glaucoma, and other vascular retinopathies. Hypercapnic acidosis (HCA) has a protective effect on lung, myocardial, and central nervous system ischemic injury models. However, no study has evaluated its protective effects in an experimental retinal I/R injury model. In this study, retinal I/R injury was induced in Sprague Dawley rats by elevating the intraocular pressure to 110 mmHg for 60 minutes. HCA was induced before and after the injury. After 24 hours, the terminal dUTP nick end labeling assay was performed. Moreover, the ratios of cleaved caspase-3/total caspase-3, phosphorylated IκB/IκB, and phosphorylated p38 were measured through Western blotting. After 7 days, the rats' aqueous humor was analyzed. In addition, electroretinography and retinal thickness measurement were performed in the rats. Moreover, the retinal neural cell line RGC-5 was exposed to 500 μM H2O2 for 24 hours to induce a sustained oxidative stress in vitro. The effects of HCA were evaluated by comparing oxidative stress, MAPK signals, NF-κB signals, survival rates, and apoptosis rates in the RGC-5 cells before and after H2O2 exposure. We further investigated whether the potent I/R-protective heat shock protein (HSP) 32 contribute to protective effects of HCA. Our results indicated that HCA has protective effects against retinal I/R injury both in vivo and in vitro, at multiple levels, including antiapoptotic, anti-inflammatory, antioxidative, and functional retinal cell protection. Further research clarifying the role of HCA in retinal I/R injury prevention and treatment is warranted.

Non-orthogonal multiple access (NOMA) is considered a promising technology for improving the spectral efficiency in fifth generation communication systems. In contrast to orthogonal multiple access (OMA), NOMA allows to allocate one frequency channel to multiple users at the same time within the same cell. Basically, this is possible through power-domain superposition coding (SC) multiplexing at transmitter and successive interference cancellation (SIC) at receiver. For this reason, either an optimal power allocation scheme and an optimal user-aggregation policy result to have a key role on NOMA systems, especially in power constrained scenarios like disaster communications. In this paper, a particle swarm optimization (PSO)-based approach for user aggregation in NOMA systems is presented. The efficiency of this approach in finding the optimal aggregation scheme which require the minimum transmission power, maintaining the quality of service (QoS) constraint of each user, is evaluated through simulations, providing comments and remarks about the obtained results.

In the present study, phenolic constituents from the rhizomes of D. bonii were isolated and their antibacterial and antioxidant activities were determined. A new compound and eight known phenolic compounds were isolated from the ethanol extract of D. bonii. The structure of the new compound was characterized by spectroscopic analysis as 3-(5-hydroxymethyl)furan-2-yl)-2-phenylacrylaldehyde (9), along with chrysophanol (1), nobiletin (2), protocatechuic acid (3), protocatechualdehyde (4), isoliquiritigenin (5), rutin (6), nicotiflorin (7), and linocaffein (8). These compounds were isolated from this plant for the first time. Most of the compounds demonstrated antibacterial and antioxidant activities, with compound 4 demonstrating especially potent antioxidant effects (SC50 4.87 μg/mL) in the DPPH test.

Euphorbia hirta L. has been proved a medicinally important plant. This study aimed to investigate the antioxidant capacities of fractioned extracts and some isolated compounds from Euphorbia hirta L. on pancreatic β-cells MIN6 exposed to hydrogen peroxide-oxidative stress conditions. Four pure compounds were isolated from ethyl acetate and methanol extracts and identified as quercitrin (1), luteolin (2), quercetin (3) and caffeic acid (4). The results showed that the ethyl acetate extract as well as quercetin possess strong protective effects with the cell viability of 81% and 82% at the dose of 0.1 mg/mL. This proves that E hirta L. is a potentially natural antioxidative plant and worth testing for further pharmacological potential in the treatment of oxidative stress which may be related to neurodegenerative diseases.

Purpose To assess the 1-year functional outcome and to evaluate the morphological changes after intravitreal injections of ranibizumab in eyes affected with retinal angiomatous proliferation (RAP) due to age-related macular degeneration (AMD). Methods A prospective, non-randomized, interventional study was conducted on 26 consecutive patients with newly diagnosed RAP. All eyes were treatment naive and were randomized to receive intravitreal injections of ranibizumab for a 12-month period. After the first three monthly injections, re-treatment was performed in case of best-corrected visual acuity (BCVA) loss of at least five letters associated with fluid within the macula, central macular thickness (CMT) increase of at least 100 mu m, and/or persistence of fluid within the macula as evaluated by optical coherence tomography, new onset macular haemorrhages, persistence of leakage from the lesions on fluorescein angiography. Results All patients completed the 12-month follow-up: 25 of the 29 treated eyes (86.2%) were stabilized, with a loss of less than 15 letters. Nineteen eyes (65.5%) maintained or improved their BCVA, and three eyes (10.3%) gained three lines or more. Overall, mean BCVA remained stable at the 12-month follow-up (-0.07 letters; P>0.05). Mean CMT significantly decreased from 386 +/- 147 to 216 +/- 74 mu m at the 12-month follow-up. No significant adverse events were observed during the study. The mean number of injections was 5.8 +/- 1.7 during the follow-up period. Conclusion The 1-year follow-up outcomes in our series suggest that ranibizumab is an effective treatment for RAP in AMD, allowing stabilization of BCVA and reduction of CMT. Eye (2010) 24, 1193-1198; doi:10.1038/eye.2010.9; published online 12 February 2010

In folk medicine of Vietnam, the plant Drynaria bonii Heinrich Christ was used for the treatment of bone disease, osteoporosis, tinnitus and stimulate hair growth, instead of Drynaria fortunei. Up to now, there are very little studies on its phytochemical as well as bioactivities of Drynaria bonii. Treatments for osteoporosis through stimulating bone formation via osteoblasts is currently concerned In this paper, we report the isolation and chemical structural determination six compounds including of 24-methylen-cycloartan-3ß-ol (1), triphyllol (2), 5-hydroxymethylfurfural (3), protocatechuic acid (4), rutin (5) and nicotiflorin (6) from the methanol extract of the rhizomes of Drynaria bonii. The cell proliferative effects of isolated compounds on MG63 osteoblast cell were also investigated. The result indicated that compounds 1, 2 and 4 stimulated the proliferation of MG63 osteoblast cells by 8.49%; 11.18 % and 7.68 % at the concentrations of 100 μg/ml, respectively. This is the first notification of six isolated compounds from Drynaria bonii and their cell proliferation activity in osteoblast-like cells.

International audience; Nanocrystalline cellulose (NCC) reinforced chitosan-based biodegradable films were prepared by solution casting. The NCC content in the films was varied from 1 to 10% (dry wt. basis). It was found that the tensile strength (TS) of the nanocomposite films with 5% (w/w) NCC content was optimum with an improvement of 26% compared to the control chitosan films. Incorporation of NCC also significantly improved barrier properties. Water vapor permeability (WVP) of the chitosan/NCC films was decreased by 27% for the optimum 5% (w/w) NCC content. Swelling studies revealed a decrease in water uptake of the NCC-reinforced chitosan films. Analyses of thermal properties showed no significant effect of NCC whereas X-ray diffraction studies confirmed the appearance of crystalline peaks in the nanocomposite films. Surface morphology of the films was investigated by scanning electron microscopy and it was found that NCC was dispersed homogenously into chitosan matrix.

Aim: The aim of this study was to evaluate the effect of c radiation on the carotenoid content of two strains of the Enterobacteriaceae: Pantoea agglomerans. Methods and Results: Pantoea agglomerans strains ATCC 49174 and RL1 were used for this study. Successive radiation treatments were performed to study the radiotolerance. Total carotenoids were obtained by multiple extraction using chloroform ⁄ methanol (2 : 1), quantified by measuring the optical density at 453 nm and their antioxidant activity measured by a colorimetric method. The D10 studies were conducted using a UC-15A irradiator loaded with 60 Co. Bacterial counts from various dilutions were carried out after irradiation. Strain ATCC 49174 irradiated at 1 kGy produced 4AE3 times more carotenoids than the control, whereas carotenoid synthesis increased by 2AE9-fold in the strain RL1. However, there was no significant difference in the D10 values. Conclusion: Carotenoid increased production is influenced by c radiation but does not modify the tolerance to radiations. Significance and Impact of the Study: To our knowledge, this is the first study to demonstrate the effects of c radiation on carotenoid production levels.

Hemolytic disease of the fetus and newborn can be effectively prevented by administration of anti-D to the mother. The administered IgG results in the attenuation of RBC-specific Ab production, a process termed Ab-mediated immune suppression (AMIS). Because in animal models of AMIS no major effect on T cell priming occurs, we hypothesized that the effect of the IgG on the immune system under AMIS conditions may involve a deficiency in B cell priming. We therefore challenged mice with either untreated RBCs or IgG-opsonized RBCs (AMIS) and assessed B cell priming. B cells from mice transfused with untreated RBCs, but not from mice treated under AMIS conditions, were primed as assessed by their ability to function as Ag-specific APCs to appropriate T cells. To our knowledge, this is the first report demonstrating that AMIS inhibits the appearance of Ag-primed RBC-specific B cells.

Haemolytic disease of the newborn (HDN) can be prevented by the passive administration of anti-D to the mother. The most accepted theory to describe this activity of anti-D is based upon its ability to clear opsonized erythrocytes before their recognition by the maternal immune system. We examined this hypothesis using a murine model of immunity to foreign erythrocytes. Whereas transfusion of foreign erythrocytes into mice induced immunoglobulin (Ig)M and IgG antibodies specific for the erythrocytes, these humoral immune responses were inhibited when the erythrocytes were opsonized with IgG. To specifically determine if immunological evasion occurs with these opsonized erythrocytes, we examined T-cell responses from these mice. An erythrocyte-specific T-cell response was clearly detected. We then tested whether phagocytosis of opsonized erythrocytes is sufficient to prevent the antibody response. We exposed mononuclear phagocytic cells to sheep red blood cells (SRBC) in vitro and then adoptively transferred the phagocytic cells to recipient mice; opsonized SRBC unexpectedly increased, rather than decreased, the antibody response. These data indicate that removal of opsonized erythrocytes by phagocytic cells does not prevent their immunological recognition and suggest that antigen clearance may not be the predominant mechanism of anti-erythrocyte action in downregulating the humoral immune response.

Nisin, a bacteriocin, was immobilized into palmitoylated alginate-based films or in activated alginate beads. Sterile beef muscle slices or ground beef were inoculated with Staphylococcus aureus at a level of 10 4 CFU/g. Sliced beef was then coated with palmitoylated alginate-based films containing 0, 500 or 1000 IU/mL of nisin. Also, ground beef was mixed with 0, 500 or 1000 IU/mL of nisin covalently linked to activated alginate beads in order to evaluate the effect of nisin concentration on S. aureus level. The content of S. aureus in beef was determined during storage at 4 °C. Results demonstrated that after 7 days of storage, a reduction of 0.91 and 1.86 log CFU/cm 2 was observed on sliced beef covered with film containing 500 or 1000 IU/mL of nisin, respectively. After 14 days of storage, when nisin solution (500 or 1000 IU/g) was mixed with ground beef, 2.2 and 2.81 log CFU/g reductions of S. aureus counts were respectively observed. However, when nisin (500 or 1000 IU/g) was linked into activated alginate beads, 1.77 and 1.93 log CFU/g reductions of S. aureus counts were respectively observed ( P ⩽ 0.05). These results suggest that sterile, hydrophobic and biodegradable films or beads incorporating various amounts of nisin could be used efficiently to control the growth of pathogens or microorganisms responsible of spoilage at the surface of round beef or other meat products.

Purpose: To assess intraobserver and interobserver agreement among physicians with different degrees of clinical experience, using a novel fundus autofluorescence semiautomated software for quantification of geographic atrophy in clinical setting. Methods: Fundus autofluorescence frames (excitation: 488 nm; emission: 500-700 nm) of 29 eyes (20 patients; mean age, 79.6 +/- 6.2 years) with geographic atrophy secondary to age-related macular degeneration, and no signs of choroidal neovascularization, were analyzed using Region Finder, a semiautomated software embedded in Spectralis (Heidelberg Engineering, Heidelberg, Germany). For each study eye, semiautomated atrophy identification and quantification were independently performed, twice (in a 2-week time frame), by 3 readers with different degrees of clinical experience (2 fellows, and 1 resident). Intraobserver and interobserver agreements were assessed. Results: Mean difference in intraobserver agreement (Bland-Altman statistics) ranged from -0.17 mm(2) to 0.13 mm(2). Intraobserver agreement was excellent until the geographic atrophy threshold value of 15.72 mm(2). Variability correlated with the size of atrophy. Mean difference in interobserver agreement (Bland-Altman statistics) ranged from -0.25 mm(2) to 0.27 mm(2), with no significant difference between senior and junior readers. Multifocal lesion or foveal involvement in atrophy was not the cause of disagreement. Conclusion: Region Finder is a reliable tool for the identification and quantification of geographic atrophy in patients with age-related macular degeneration, in a clinical setting even when performed by junior reader.

Introduction Afin d’etablir une classification fiable sur laquelle pourront se baser des etudes cliniques ou genetiques, il est necessaire de pouvoir determiner des sous-groupes homogenes de degenerescence maculaire liee a l’âge (DMLA) a partir de l’examen clinique, angiographique et OCT. La premiere partie de notre etude (SPA-1) porte sur le phenotypage des precurseurs de la maculopathie liee a l’âge base sur l’angiographie a la fluoresceine. Patients et methodes Trente items portant sur la classification des stades precoces de DMLA, de la neovascularisation choroidienne et de l’atrophie ont ete selectionnes a partir de la litterature. Vingt yeux de vingt patients consecutifs ont ete choisis a partir d’une etude prospective NAT-2, incluant des formes variees de precurseurs. La cotation a ete basee sur les photographies couleur du fond d’œil, les cliches anerythres et l’angiographie a la fluoresceine. Pour chaque cas, la grille a ete remplie par quatre observateurs independants et un expert. La variance intra-patient a ete etudiee pour chaque item. Resultats L’accord le plus pertinent entre observateurs est retrouve pour l’item « decollement drusenoide de l’epithelium pigmentaire » (variance intra-patient = 0,000). La plus mauvaise valeur pour la variance intra-patient concerne l’item « drusen intermediaire entre 5 et 20 » (variance intra-patient = 0,255). Conclusion Cette evaluation de la premiere partie de notre grille demontre un accord satisfaisant entre observateurs pour la plupart des items. Concernant l’item avec le plus faible accord, il sera amene a etre modifie apres concertation des differents medecins. A terme, elle pourrait etre utilisee dans des etudes futures cliniques ou genetiques.

Purpose: The purpose of this study was to understand clinical significance of near-infrared reflectance (NIR), blue fundus autofluorescence (FAF) and near-infrared autofluorescence (NIA) in dry age-related macular degeneration (AMD), by correlation with fluorescein angiography (FA) and cross-sectional spectral domain optical coherence tomography (SD OCT). Methods: We evaluated 110 eyes (62 patients, mean age: 64 ± 8 years) diagnosed with dry AMD between January 2010 and December 2010, which underwent NIR (λ = 830 nm), FAF and FA (excitation λ = 488 nm; emission λ > 500 nm), NIA (excitation λ = 787 nm; emission λ > 800 nm), and simultaneous SD OCT scanning using a combined confocal scanning laser ophthalmoscope/SD OCT device (Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany). Results: Drusen showed variable increased/decreased NIR, FAF, NIA and FA, which corresponded to variable increased/decreased thickness of the retinal pigment epithelium (RPE) and possible presence of subretinal deposits on SD OCT. Geographic atrophy (GA) was present in 43/110 eyes (39.0%) and showed increased NIR and fluorescence (FA), absent FAF and NIA, and loss of RPE on SD OCT. The hyperautofluorescence of the GA margin was never larger in FAF than that in NIA, while in 16.2% of cases, it was larger in NIA than that in FAF and corresponded to mild choroidal hyperreflectivity on SD OCT. Conclusions: Simultaneous recording of SD OCT scans provided ultrastructural data for the evaluation of NIR, FAF, NIA and FA in dry AMD. Near-infrared autofluorescence might detect earlier than FAF areas of RPE cell loss at the GA margin.

A fructose-fed hamster model of insulin resistance was previously documented to exhibit marked hepatic very low density lipoprotein (VLDL) overproduction. Here, we investigated whether VLDL overproduction was associated with down-regulation of hepatic insulin signaling and insulin resistance. Hepatocytes isolated from fructose-fed hamsters exhibited significantly reduced tyrosine phosphorylation of the insulin receptor and insulin receptor substrates 1 and 2. Phosphatidylinositol 3-kinase activity as well as insulin-stimulated Akt-Ser473 and Akt-Thr308 phosphorylation were also significantly reduced with fructose feeding. Interestingly, the protein mass and activity of protein-tyrosine phosphatase-1B (PTP-1B) were significantly higher in fructose-fed hamster hepatocytes. Chronic ex vivo exposure of control hamster hepatocytes to high insulin also appeared to attenuate insulin signaling and increase PTP-1B. Elevation in PTP-1B coincided with marked suppression of ER-60, a cysteine protease postulated to play a role in intracellular apoB degradation, and an increase in the synthesis and secretion of apoB. Sodium orthovanadate, a general phosphatase inhibitor, partially restored insulin receptor phosphorylation and significantly reduced apoB secretion. In summary, we hypothesize that fructose feeding induces hepatic insulin resistance at least in part via an increase in expression of PTP-1B. Induction of hepatic insulin resistance may then contribute to reduced apoB degradation and enhanced VLDL particle assembly and secretion.

Color analysis on apple and potato slices coated with calcium caseinate or whey protein solutions showed that the 2 coatings efficiently delayed browning by acting as oxygen barriers. The antioxidant properties of the films were realized using a model allowing the release of oxidative species by electrolysis of saline buffer. Whey proteins were a better antioxidant capacity than calcium caseinate. Furthermore, addition of carboxymethyl cellulose (CMC) to the formulations significantly improved their antioxidative power. Best scavenging of oxygen free radicals and reactive oxygen species was found for films based on whey proteins and CMC which inhibited by 75% the formation of colored compounds produced by the reaction of the oxidative species with N,N-diethyl-p-phenylenediamine.

The regulation of insulin receptor (IR) tyrosine (tyr) phosphorylation is a key step in the control of insulin signaling. Augmented IR tyr dephosphorylation by protein tyrosine phosphatases (PTPs) may contribute to insulin resistance. To investigate this possibility in hyperglycemia-induced insulin resistance, primary cultured rat adipocytes were rendered insulin-resistant by chronic exposure (18 h) to 15 mmo/l glucose combined with 10(-7) mol/l insulin. Insulin-resistant adipocytes showed a decrease in insulin sensitivity and a maximum response of 2-deoxyglucose uptake, which was associated with a decrease in maximum insulin-stimulated IR tyr phosphorylation in situ. To assess tyr dephosphorylation, IRs of insulin-stimulated permeabilized adipocytes were labeled with [gamma-32P]ATP and chased for 2 min with unlabeled ATP in the presence of EDTA. In a nonradioactive protocol, insulin-stimulated adipocytes were permeabilized and exposed to EDTA and erbstatin for 2 min, and IRs were immunoblotted with anti-phosphotyrosine (pY) antibodies. Both methods showed a similar diminished extent of IR tyr dephosphorylation in resistant cells. Immunoblotting of four candidate IR-PTPs demonstrated no change in PTP1B or the SH2 domain containing phosphatase-2 (SHP-2), whereas a significant decrease in leukocyte antigen-related phosphatase (LAR) (51 +/- 3% of control) and an increase in PTP-alpha (165 +/- 16%) were found. Activity of immunoprecipitated PTPs toward a triple tyr phosphorylated IR peptide revealed a correlation with protein content for PTP1B, SHP-2, and LAR but a decrease in apparent specific activity of PTP-alpha. The data indicate that decreased IR tyr phosphorylation in hyperglycemia-induced insulin resistance is not due to enhanced dephosphorylation. The diminished IR tyr dephosphorylation observed in this model is associated with decreased LAR protein content and activity.

This video presents the in-house developed DLR MiroSurge robotic system for surgery. As shown, the system is suitable for both minimally invasive and open surgery. Essential part of the system is the MIRO robot: The soft robotics feature enables intuitive interaction with the robot.

Anti-D has been widely and effectively used in Rhesus blood group D negative mothers for the prevention of haemolytic disease of the fetus and newborn; its mechanism of action however, often referred to as antibody-mediated immune suppression (AMIS), remains largely unresolved. We investigated, in a murine model, whether active immune suppression or clonal deletion mediated by anti-red blood cell (RBC) immunoglobulin G (IgG) could explain the phenomenon of AMIS. Transfusion of IgG-opsonized foreign RBCs (i.e. AMIS) strongly attenuated antibody responses compared to transfusion of untreated foreign RBCs. When the AMIS-mice were subsequently transfused with untreated RBCs, no immune suppression was observed at 5 and 35 days after AMIS induction; in fact, the mice responded to retransfusion with untreated RBCs in a manner that was characteristic of a secondary immune response. When IgG-opsonized RBCs were transfused concurrently with untreated RBCs, a dose-dependent reduction of the antibody response was observed. This work suggests that the attenuation of the antibody responsiveness by anti-RBC IgG is not associated with active immune suppression or clonal deletion at either the T-cell or B-cell level; rather, the effect appears more characteristic of B-cell unresponsiveness to IgG-opsonized RBCs. These results may have implications for the understanding of the mechanism of action of anti-D in haemolytic disease of the fetus and newborn.

Objective: To report a novel surgical procedure to displace retained subfoveal perfluorocarbon liquid (PFCL). Methods:Retrospective cases series. Three patients had retained subfoveal droplets after PFCL was used in vitrectomy repair of retinal detachment. In each case, submacular PFCL was displaced to the subretinal space in the inferior periphery. A retinal detachment at the posterior pole and the inferior periphery was created by injecting balanced salt solution through a retinal puncture near the inferotemporal vessels. Fluid-air exchange wasperformed,followedbyshort-termpostoperativeupright head positioning. Results: In all cases, PFCL droplets were successfully displaced toward the inferior periphery, with good visual recovery. Conclusion: This procedure seems to be safe and is an alternative to direct aspiration of PFCL through a juxtafoveal retinotomy, which risks damage to the foveal region.

Purpose To evaluate the interobserver and intraobserver reliability of detecting early and late age-related macular degeneration (AMD) using a nonmydriatic digital camera in two distinct groups of older people. Design Prospective study. Methods The two groups consisted of a series of patients older than 70 years hospitalized in a geriatric unit and a younger series of people older than 55 years. In both groups, nonmydriatic color fundus photographs were obtained and graded independently by two ophthalmologists (V.L. and M.S.). No ophthalmic examination was performed. Main outcome measures were frequencies of early and late AMD and interobserver and intraobserver agreement. Results Among 233 patients in group 1 (mean age, 84.6 years), only 119 patients (51%) could undergo photography because of associated multiple morbidities. Mean age of group 2 was 63.8 years. In group 1, 35 (14.5%) of 238 pictures were ungradable. In series 2, 65 (9.1%) of 716 pictures were ungradable. Frequencies of early and late AMD were 30.3% and 5.9% vs 12.6% and 2.6% in series 1 and 2, respectively. Interobserver and intraobserver agreement was good or excellent (κ > 0.6) in both groups. Conclusions In the entire geriatric cohort, 43% of the patients had gradable pictures allowing a diagnosis. These patients would otherwise have had no access to any form of funduscopy. In the younger population, nonmydriatic pictures permitted a diagnosis in 90% of the individuals. Detection of AMD with a nonmydriatic digital camera may lead to large-scale screening and specific management.