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目的：多重用藥(polypharmacy)、高齡及藥品處方複雜都是影響病人用藥安全的風險因子，文獻結果顯示用藥整合提供病人生理層面的用藥安全維護，減少多重用藥和處方複雜造成的風險，本研究以某醫院的用藥整合服務紀錄，分析藥師提供的用藥整合服務成效，並探討病人在用藥整合過程中表示的全人照護需求與藥師提供的服務。 方法：本研究的資料為某醫院2019年度的用藥整合服務紀錄，分析項目包括服務對象資料、用藥品項數目與頻次、醫療資源使用型態與用藥指導項目，並統計用藥整合服務後用藥品項與頻次的變化以及訪談諮詢櫃台藥師，調查病人接受用藥服務後回饋的意見，用藥複雜度以medication regimen complexity index (MRCI)評量。 結果：本研究共分析219位病人接受用藥整合服務的紀錄，病人年齡中位數為71.5歲，每人正在用藥科別中位數為2科，MRCI中位數為29分。經過藥師進行整合服務後，有28位病人的用藥數量及用藥複雜度降低，整合服務前每人用藥數目的中位數為15項，整合後用藥數目的中位數降為11.5項，減少的用藥顆數的中位數為30顆；整合前MRCI中位數為35.8分，整合後下降至30.3分。在17件服務紀錄中有紀錄到心理與社會層面的全人照護，其中藥師提供的心理層面照護共9項，社會層面的照護共8項。 結論：在本研究中MRCI與醫療資源使用程度有關，高醫療資源使用的病人，MRCI中位數顯著較高，代表用藥較為複雜度，發生遵醫囑性不佳的風險較高。對於高醫療資源使用、使用特殊劑型且同時有多種疾病的病人，需要醫療專業人員的合作，進行用藥的全面評估與整合，減少用藥複雜度，降低重覆用藥與遵醫囑性不佳等情形。 Background: Polypharmacy, aging, and complex medication regimen are risk factors for adverse drug effect. Literature indicates that medication reconciliation helps increase medication safety and reduce the risk of polypharmacy and complex medication. We analyzed medication reconciliation records of our hospital to evaluate the efficacy of the medication reconciliation service offered by our pharmacists based on the holistic needs of the patients and the responses of our pharmacists to the needs. Methods: Medication reconciliation record in 2019 in one hospital was analyzed, including patient profile, number of medication, dosage and frequency of medication, health resource demand and patient education. Changes in medication dosage and frequency were analyzed, and pharmacists were interviewed to obtain patient’s feedback about medication reconciliation service. Medication regimen complexity index (MRCI) was used to measure the complexity of the regimen. Results: A total of 219 medication reconciliation records were analyzed, and the median of age of patients was 71.5 years. Patient’s medication was prescribed from one or multiple clinics; the median of clinics was 2. The median of MRCI score was 29. Pharmacists had reduced 28 patients’ medication number and MRCI score after reconciliation service. For the 28 patients, the median of medication before and after the reconciliation service were 15 and 11.5. With the service, the median of reduced tablets was 30, leading to a drop from 35.8 to 30.3 in the median of MRCI score. Seventeen records showed patients with psychological and social needs, and pharmacists responded by providing 9 patients with psychological support and health care resources and 8 patients with social support and services. Conclusion: MRCI is correlated with the degree of health resource utilization. Patients with a higher demand for health resource tend to report a higher MRCI score and more complex medication regimen. The risk of medication nonadherence is increased with higher medication complexity. For patients consuming greater health resource, using special formulation of medicine, and with multiple comorbidities, health care professionals should perform comprehensive assessment for medication reconciliation to help decrease the risk of polypharmacy and medication nonadherence. &nbsp

The peculiar features of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), are challenging the current biological knowledge. Early in Feb, 2020, we suggested that SARS-CoV-2 may possess neuroinvasive potential similar to that of many other coronaviruses. Since then, a variety of neurological manifestations have been associated with SARS-CoV-2 infection, which was supported in some patients with neuroimaging and/or cerebrospinal fluid tests. To date, at least 27 autopsy studies on the brains of COVID-19 patients can be retrieved through PubMed/MEDLINE, among which neuropathological alterations were observed in the brainstem in 78 of 134 examined patients, and SARS-CoV-2 nucleic acid and viral proteins were detected in the brainstem in 16/49 (32.7%) and 18/71 (25.3%) cases, respectively. To shed some light on the peculiar respiratory manifestations of COVID-19 patients, this review assessed the existing evidence about the neurogenic mechanism underlying the respiratory failure induced by SARS-CoV-2 infection. Acknowledging the neurological involvement has important guiding significance for the prevention, treatment, and prognosis of SARS-CoV-2 infection.

The efficacy and safety of proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease (ASCVD).This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention (PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events (MACE) over six months were compared between two groups. A propensity score-matched (PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE.In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol (LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81% (In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study.

Objective and background Recently, decellularized matrix (DCM) is considered as a new biomaterial for tissue regeneration. To explore the possible application of DCM in periodontal regeneration, the effect of DCM from three different cells on the proliferation and differentiation of human periodontal ligament stem cells (PDLSCs) was investigated. Methods DCM derived from human periodontal ligament cells (PDLCs), dental pulp cells (DPCs), and gingival fibroblasts (GFs) were fabricated using Triton X-100/NH4 OH combined with DNase I. Allogeneic PDLSCs were cultured on PDLC-DCM, DPC-DCM, and GF-DCM, respectively. The proliferative capacity of PDLSCs was evaluated by PicoGreen assay kit. The expression of alkaline phosphatase (ALP), runt-related transcription factor-2 (RUNX2), osteocalcin (OCN), collagen I (COL1), periostin (POSTN), and cementum protein 1 (CEMP1) were detected by qRT-PCR and western blotting. Results PDLC-DCM, DPC-DCM, and GF-DCM had similar and integrated networks of extracellular matrix, as well as significantly decreased DNA content. Compared with control group in which PDLSCs were directly seeded in culture plates, PDLC-DCM, DPC-DCM, and GF-DCM promoted the proliferation of re-seeded PDLSCs. Additionally, PDLSCs on DCM exhibited higher mRNA and protein expression levels of ALP, RUNX2, OCN, and COL1. The expression of POSTN in PDLC-DCM group was significantly higher than control group at both mRNA and protein levels. Conclusions PDLC-DCM, DPC-DCM, and GF-DCM could enhance the proliferation of PDLSCs. PDLC-DCM facilitated osteogenic differentiation and periodontal ligament differentiation of PDLSCs, while DPC-DCM and GF-DCM promoted osteogenic differentiation.

Periodontitis is a chronic inflammatory disease characterized by loss of attachment and destruction of the periodontium. Decellularized sheet, as an advanced tissue regeneration engineering biomaterial, has been researched and applied in many fields, but its effects on periodontal regeneration remain unclear. In this study, the biological properties of decellularized human periodontal ligament cell (dHPDLC) sheets were evaluated in vitro. Polycaprolactone/gelatin (PCL/GE) nanofibers were fabricated as a carrier to enhance the mechanical strength of the dHPDLC sheet. 15-deoxy-[Formula: see text]-prostaglandin J

It is still a challenge to optimize the component distribution and microporous structures in scaffolds for tailoring biodegradation (ion releasing) and enhancing bone defect repair within an expected time stage. Herein, the core–shell-typed nonstoichiometric wollastonite (4% and 10% Mg-doping calcium silicate; CSiMg4, CSiMg10) macroporous scaffolds with microporous shells (adding ∼10 μm PS microspheres into shell-layer slurry) were fabricated via 3D printing. The initial mechanical properties and bio-dissolution (ion releasing) in vitro, and osteogenic capacity in vivo of the bioceramic scaffolds were evaluated systematically. It was shown that endowing high-density micropores in the sparingly dissolvable CSiMg10 or dissolvable CSiMg4 shell layer inevitably led to nearly 30% reduction of compressive strength, but such micropores could readily tune the ion release behaviour of the scaffolds (CSiMg4@CSiMg10 vs. CSiMg4@CSiMg10-p; CSiMg10@CSiMg4 vs. CSiMg10@CSiMg4-p). Based on the in rabbit femoral bone defect repair model, the 3D μCT reconstruction and histological observation demonstrated that the CSiMg4@CSiMg10-p scaffolds displayed markedly higher osteogenic capability than the other scaffolds after 12 weeks of implantation. It demonstrated that core–shell bioceramic 3D printing technique can be developed to fabricate single-phase or biphasic bioactive ceramic scaffolds with accurately tailored filament biodegradation for promoting bone defect regeneration and repair in some specific pathological conditions.

The high student-to-faculty ratio is an obstacle in the reform of teaching methods in master's programmes of nursing education in China. Though Kim's study showed that team-based learning (TBL) can be implemented in high student-to-faculty ratio classes, it is still a challenge for students accustomed to the traditional didactic lecture (TDL) teaching method, and the lack of an inclusive design model has restricted the effective application of TBL.To compare the effect of TBL on postgraduate nursing students with lecture-based teaching with small group discussion (LBTWSGD) and to clarify key factors to promote the effective application of TBL.A quasi-experimental study design. We selected 27 unbiased participants in the applied LBTWSGD group and 48 participants in the applied TBL group and conducted questionnaire surveys at the last day of the course which lasted for 10 weeks. Students' self-directed learning ability was assessed by the Self-Directed Learning Instrument (SDLI), classroom engagement was assessed by the Self-Report of Engagement Measure (SREM), and students' evaluation of the teaching experience was assessed by the Student Evaluation of Teaching and Units (SETU). A difference analysis between the two groups was performed by the SETU. The mean and standard deviation of each tool were calculated and compared between the two groups.The study determined that compared to LBTWSGD, TBL significantly improved students' self-directed learning (p 0.01) and classroom engagement (p 0.05). The scores for 6 of 9 items in the SETU were significantly higher in the TBL group than in the LBTWSGD group.The TBL teaching method can effectively improve nursing students' self-learning ability and classroom engagement through effective teacher feedback, discussion, and communication. The same clear and definite reading assignments in TBL can help students obtain effective teacher feedback and form effective discussions and communication.

The outbreak of coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), has become a significant and urgent threat to the global health. This review provided strong support for CNS infection with SARS‐CoV‐2 and shed light on neurological mechanism underlying the lethality of SARS‐CoV‐2 infection. Among the published data, only 1.28% COVID‐19 patients who underwent cerebrospinal fluid (CSF) tests were positive to SARS‐CoV‐2 in CSF. However, this does not mean the absence of CNS infection in most COVID‐19 patients, because postmortem studies revealed that some patients with CNS infection showed negative results in CSF tests for SARS‐CoV‐2. Among 20 neuropathological studies reported so far, SARS‐CoV‐2 was detected in the brain of 58 cases in 9 studies, and three studies have provided sufficient details on the CNS infection in COVID‐19 patients. Almost all in vitro and in vivo experiments support the neuroinvasive potential of SARS‐CoV‐2. In infected animals, SARS‐CoV‐2 was found within neurons in different brain areas with a wide spectrum of neuropathology, consistent with the reported clinical symptoms in COVID‐19 patients. Several lines of evidence indicate that SARS‐CoV‐2 used hematopoietic route to enter the CNS. But more evidence supports the trans‐neuronal hypothesis. SARS‐CoV‐2 has been found to invade the brain via the olfactory, gustatory and trigeminal pathways, especially at the early stage of infection. Severe COVID‐19 patients with neurological deficits are at a higher risk of mortality, and only the infected animals showing neurological symptoms became dead, suggesting that neurological involvement may be one cause of death. This article is protected by copyright. All rights reserved.

Background The efficacy and safety of PCSK-9 inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China is unknown. Objective To describe the real world effectiveness of initiated with PCSK-9 inhibitors combined with statins compared with statins among patients with very high risk of ASCVD and underwent percutaneous coronary intervention (PCI). Methods This is a prospective study, enrolled patients from 32 hospitals between January to June 2019. The lipid control rate and incidence of cardiovascular events over 6 months were compared between two groups. A propensity score-matched analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for cardiovascular events. Results In a total of 3063 patients, 89.91% had received moderate or high-intensity statin therapy before PCI, but only 9.47% had LDL levels below 1.4mmol/L at baseline. In the PSM selected patients, LDL level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81% (P

Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice.This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF.A total of 626 severe HF patients with New York Heart Association (NYHA) class III-IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change10%. A p-value lower than 0.05 was considered significant.Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death.In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.A fração de ejeção (FE) tem sido utilizada em análises fenotípicas e na tomada de decisões sobre o tratamento de insuficiência cardíaca (IC). Assim, a FE tornou-se parte fundamental da prática clínica diária.Este estudo tem como objetivo investigar características, preditores e desfechos associados a alterações da FE em pacientes com diferentes tipos de IC grave.Foram incluídos neste estudo 626 pacientes com IC grave e classe III–IV da New York Heart Association (NYHA). Os pacientes foram classificados em três grupos de acordo com as alterações da FE, ou seja, FE aumentada (FE-A), definida como aumento da FE ≥10%, FE diminuída (FE-D), definida como diminuição da FE ≥10%, e FE estável (FE-E), definida como alteração da FE10%. Valores p inferiores a 0,05 foram considerados significativos.Dos 377 pacientes com IC grave, 23,3% apresentaram FE-A, 59,5% apresentaram FE-E e 17,2% apresentaram FE-D. Os resultados mostraram ainda 68,2% de insuficiência cardíaca com fração de ejeção reduzida (ICFEr) no grupo FE-A e 64,6% de insuficiência cardíaca com fração de ejeção preservada (ICFEp) no grupo FE-D. Os preditores de FE-A identificados foram faixa etária mais jovem, ausência de diabetes e fração de ejeção do ventrículo esquerdo (FEVE) menor. Já os preditores de FE-D encontrados foram ausência de fibrilação atrial, baixos níveis de ácido úrico e maior FEVE. Em um seguimento mediano de 40 meses, 44,8% dos pacientes foram vítimas de morte por todas as causas.Na IC grave, a ICFEr apresentou maior percentual no grupo FE-A e a ICFEp foi mais comum no grupo FE-D.

Background Dentine hypersensitivity (DH) could occur or intensify after non-surgical periodontal therapy because of the exposure of dentine tubules, but currently no gold standard exists to treat DH. It has been demonstrated that nano-sized particles presented potential for dentine tubules blocking and remineralization. This randomized controlled trial aimed to investigate the efficacy of dentifrice containing nano-carbonate apatite (n-CAP) in reducing dentine hypersensitivity (DH) after non-surgical periodontal therapy. Methods 48 periodontitis patients with DH were included in this clinical trial. After non-surgical periodontal therapy, patients included were randomized to test and control group and the respective dentifrices were applied at chairside, after which they were instructed to brush teeth with the allocated dentifrices twice a day at home. Periodontal parameters were recorded at baseline and the last follow-up. DH was measured by air-blast test and recorded by visual analogue scale (VAS) and Schiff sensitivity scale at baseline, after polishing (0 week) and 2/4/6 weeks. Results 45 participants completed the follow-up. Periodontal parameters were improved and comparable between groups. Significant reduction in DH was observed in both groups at all time-points compared to baseline in terms of VAS and Schiff score. The test group achieved significantly greater relief from hypersensitivity compared with the control group after 4-week at-home use (for change of VAS, test group: 2.27 ± 2.47 versus control group: 1.68 ± 2.24, p = 0.036; for change of Schiff, test group: 0.94 ± 0.92 versus control group: 0.61 ± 0.83, p p = 0.027) and no significance in terms of change of VAS (p = 0.256). Conclusions Home-use of n-CAP based dentifrice had some benefit on alleviation of DH following non-surgical periodontal therapy after 4 weeks compared to the control product. Trial registration Chinese Clinical Trials Registry (No. ChiCTR-IPR-17011678, http://www.chictr.org.cn/, registered 16 June, 2017).

Arias intensity ( I A ) and peak ground acceleration (PGA) have been widely used as measures of the intensity of strong ground motions. This study employs a large set of data consisting of 7034 horizontal and 3474 vertical strong‐motion records from 173 worldwide earthquakes ( M w 4.3–7.9) to refine the relationship between I A and PGA and investigates its potential dependence on variables such as earthquake magnitude ( M w ), local site condition ( V S 30 ), focal mechanism, and fault distance. The dataset from the 2011 M w 9.0 Tohoku earthquake and the 2013 M w 6.8 Lushan earthquake is used to demonstrate the usability and necessity of our models. The results reveal that the logarithm of I A increases linearly with the increase of the logarithm of PGA and M w and the decrease of the logarithm of V S 30 , and this kind of correlation is not significantly affected by focal mechanism and fault distance. New global empirical relationships for both horizontal and vertical components are developed to estimate I A as a function of PGA, M w , and V S 30 . The resulting correlation equations presented in this article represent a significant advancement by incorporating such important features as magnitude and V S 30 and enable an improved way of estimating I A from PGA. Online Material: Table of earthquake parameters.

To improve the corrosion resistance and mechanical properties of AM50 magnesium alloy, T6 heat treatment was applied. The microstructure, mechanical properties and corrosion properties of as-cast and T6 heat-treated alloy were studied. The results indicated that the β phase presented at the grain boundaries along with Al–Mn phase after T6 heat-treatment. Because of solid solution and aging treatments, the tensile strength of the AM50 magnesium alloy was increased. The decreasing of the β phase owing to the solidsolution during T6 treatment, which causes Al solid solution in the α-Mg phase, and it is favourable for increasing the corrosion resistance of AM50 magnesium alloy. The fracture mechanisms of the as-cast and T6 heat-treated alloy were quasi-cleavage fracture. The corrosion residual strength of the T6 heat-treated alloy was higher than that of the as-cast alloy. Compared with the as-cast alloy, the corrosion rate of the T6 heat-treated alloy decreased gradually.

Arias intensity is a measure of earthquake intensity that captures the potential destructiveness of an earthquake. Using the strong ground motion records of the M w 7.6 Chi‐Chi earthquake, Taiwan, we analyze the spatial distribution of the vertical, horizontal, fault‐parallel, and fault‐normal components of the Arias intensity. We investigate the effects of the hanging wall and footwall on ground motions, and develop a relationship between Arias intensity and peak ground acceleration (PGA), incorporating the influence of local site conditions. We also evaluate the applicability of some widely used Arias intensity attenuation relationships by comparing the observed values with empirical estimates. Our results show the vertical Arias intensity is generally lower than the horizontal component, with nearly 90% of the vertical‐to‐horizontal ratios between 0.1 and 0.6. During this typical reverse mechanism earthquake, the fault‐normal component of the Arias intensity is approximately 20% higher than the fault‐parallel component for sites within 40 km of the fault. Arias intensities on the hanging wall are systematically higher than those on the footwall, indicating clear hanging‐wall effects. Site conditions influence the correlation between Arias intensity and PGA. Arias intensity shows a good correlation with PGA and V S 30. Arias intensity increases with increasing PGA and decreasing V S 30. The Arias intensities observed within 40 km of site class C locations, and within 80 km of site class D locations, are generally lower than the mean estimates from empirical predictions. In contrast, at distances of >80 km from site class D locations, the observed Arias intensities are much larger than the empirical predictions as a result of site amplification. Considering the variability of ground motion between earthquakes, the attenuation model of Travasarou et al. (2003), model 4 of Stafford et al. (2009), and the model of Lee et al. (2012) provide a good fit with observations from the Chi‐Chi earthquake. Online Material: Table of station coordinates, fault distances, footwall/hanging wall indicator, site classes, V S 30, and measured Arias intensities.

The coloured ceramic coating was prepared by using micro-arc oxidation technology on aluminium. CuSO4 was used as the colourant to produce the brown micro-arc oxidation coating. The effects of the applied current density on characteristics and properties of the micro-arc oxidation coating were studied. The results showed that there were significant changes on colour, surface morphology, thickness and corrosion resistance of the micro-arc oxidation coating when the current density increased: The colour deepened, and the pore size increased. In addition, the thickness of the micro-arc oxidation coating rose, and the roughness of the coating increased gradually. But the corrosion resistance of the micro-arc oxidation coating increased when the current density increased from 4 to 7 A dm−2, and then it dropped when the current density increased from 7 to 8 A dm−2.

Objectives This review aims to evaluate the efficacy of xenogeneic collagen matrix (XCM) for the treatment of single or multiple gingival recessions in terms of clinical parameters and patient-related outcomes. Materials and methods Various electronic databases (The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, etc.) from 1966 to April 2018 and hand literatures were searched. Quality of the included studies was assessed through the Cochrane Collaboration's Risk of Bias tool. A meta-analysis was performed to calculate risk ratios and mean differences. Results Nine randomized controlled trials were included. The results revealed a higher percentage of mean root coverage (MRC) and a greater recession reduction (RecRed) for single recessions for the combination of coronally advanced flap (CAF) with XCM compared to CAF alone (n = 3; MD = 10.00%; 95%CI [3.56%; 16.43%]; p = 0.002) (n = 3; MD = 0.35 mm; 95%CI [0.10 mm; 0.60 mm]; p = 0.005). Comparing XCM with connective tissue graft (CTG), no significant differences were detected in MRC or RecRed for single and multiple recessions. Conclusions The addition of XCM under CAF could improve MRC and RecRed at single tooth recessions. Initial data suggest that XCM shows promising results to improve the clinical efficacy of CAF for multiple recessions. In addition, XCM could be a valid alternative to CTG in terms of MRC and RecRed at both single and multiple recessions. Based on limited evidence, XCM may decrease postoperative morbidity and operation time compared to CTG.

This study aims to investigate the predictive value of pre-chemotherapy β1R-AABs by evaluating the response of newly diagnosed symptomatic multiple myeloma (MM) patients to their treatment with a bortezomib-containing regimen. Forty-five de novo MM patients and 50 normal controls (NCs) were prospectively enrolled in this study. Serum titers of β1R-AABs were detected by ELISA. These 45 MM patients were divided into two groups (positive and negative groups) according to their β1R-AABs. Follow-up examinations were performed on these patients during chemotherapy induction. The final analysis covered all 45 MM patients, including 19 patients who were positive for MM and 26 patients who were negative for MM. Multivariate analysis revealed that pre-chemotherapy β1R-AABs are possibly independent predictors for less than very good partial response (VGPR) after the bortezomib-containing regimen treatment (odds ratio: 5.967, 95% confidence interval: 1.513-23.531; p = .011). This study demonstrates for the first time that the presence of β1R-AABs is associated with MM. Pre-chemotherapy β1R-AABs are independent predictors for less than VGPR in de novo MM patients after the bortezomib-containing regimen was administrated. Bortezomib might not significantly give rise to cardiac impairment in MM patients.

Whether rapamycin has neuroprotective effects in spinal cord injury remains controversial. The present study shows that rapamycin protects neurons from death after spinal cord injury by inhibiting the secondary inflammatory response. The effects of rapamycin were tested using a myeloperoxidase assay, Western blotting, immunohistochemistry, and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The experimental results showed that after spinal cord injury, rapamycin reduced the numbers of activated microglia and neutrophils in the damage zone, lowered the expression levels of TNF-α and IL-1β, reduced the apoptotic cells, and increased the survival of neurons. The above data proved that rapamycin diminishes inflammatory cell activation and proliferation, downregulates the expression of inflammatory factors, reduces the microenvironmental damage effects on neurons in the acute injury phase, and thus promotes the survival of neurons. Therefore, we believe that rapamycin has neuroprotective effects in spinal cord injury.

After spinal cord injury (SCI), a series of complex pathophysiological processes follows the initial injury. Because inflammation plays a key role in this secondary pathology damage, anti-inflammatory drug treatment may reduce secondary damage and protect neurons after SCI. Though nordihydroguaiaretic acid (NDGA) can inhibit inflammatory responses, its potential roles in neuroprotection and anti- inflammation in an SCI model have not been studied. In this study, we investigated the anti-inflammatory effects of NDGA in SCI. First, histopathological alterations were evaluated with hematoxylin/eosin (HE) and Nissl staining, showing an increased number of neurons after NDGA administration. Additionally, the extent of secondary damage was assessed by TUNEL assay and measurement of astrocyte proliferation. The data showed that the numbers of apoptotic cells and the proliferative extent of astrocytes were significantly decreased by the use of NDGA. The anti-inflammatory effect of NDGA was evaluated by measuring myeloperoxidase (MPO) levels as an indicator of neutrophil activity, macrophage/microglia numbers, and expression of inflammatory cytokines including IL-1β and TNF-α. NDGA treatment significantly decreased the MPO level and the number of macrophages/microglia. In addition, NDGA also suppressed the expression of IL-1β and TNF-α after SCI. These data suggest that anti-inflammatory action by NDGA can reduce secondary damage after SCI.

Neural stem cells (NSCs) are usually affected by a number of biological functions in neural traumatic and degenerative diseases. Autophagy may be involved in these diseases. However, whether autophagy could affect NSCs is largely unknown. Therefore, we aimed to investigate intracellular microstructures, proliferation, axon extension, and Beclin-1 expression of rat NSCs by basic culture medium and conditioned medium without epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF). Transmission electron microscopy showed the formation of autophagic vacuoles in conditioned medium. Compared to the control group with normal medium, the number of secondary neurosphere was significantly reduced whereas the expression of Beclin-1 was enhanced. The majority of NSCs were nestin-positive when EGF/bFGF was withdrawn for 3 days and showed enhanced neurite extension, which was suppressed by autophagy antagonist 3-methyladenine. Our findings revealed that a short-term paucity of mitogens in microenvironments could induce autophagy of NSCs, which facilitated NSCs' axonal growth.

Bridging strategies are essential for spinal cord repair in order to provide a physical substrate allowing axons to grow across the site of spinal cord lesions. In this study, we have evaluated the therapeutic effects of adding amniotic epithelial cells to a unidirectionally oriented acellular muscle scaffold and have compared this with the effect of a scaffold alone. Chemically extracted acellular muscles, with or without amniotic epithelial cells, were implanted into the lateral hemisected adult rat thoracic spinal cord. Control rats were similarly injured. After 4 weeks, the acellular muscle scaffolds were found to be well integrated with the host tissue. The chemically extracted acellular muscle scaffold seeded with amniotic epithelial cells promoted axonal growth in a distinctly organized and linear fashion, induced sprouting of calcitonin gene-related peptide positive axons, and was not associated with an astrocyte response. Compared with acellular muscle scaffolds alone, the addition of amniotic epithelial cells further promoted the remyelination of nerve fibers, sprouting of 5-hydroxytryptamine nerve fibers, relays of cortical motor-evoked potential and cortical somatosensory-evoked potential, and functional recovery. All these data together suggest that co-implantation of chemically extracted acellular muscle with amniotic epithelial cells may constitute a valuable approach to study and/or develop therapies for spinal cord injury.

We report a efficient compact red laser at 671 nm generation by intracavity frequency doubling of a continuous wave laser operation of a diode pumped Nd:Lu0.5Y0.5VO4 laser on the 4 F 3/2-4 I 13/2 transition at 1342 nm. An LBO crystal, cut for critical type I phase matching at room temperature is used for second harmonic generation of the laser. At an absorbed pump power of 17.8 W, as high as 2.25 W of continuous wave output power at 671 nm is achieved with 10-mm-long LBO. The optical-to-optical conversion efficiency is up to 12.6%, and the fluctuation of the red output power was better than 3.6% in the given 30 min.

A Nd:YVO4 crystal was pumped directly into the emitting level by a laser diode at 914 nm. We achieved an output power of 1.46 W at 1342 nm for an incident pump power of 18.3 W, corresponding to an optical-to-optical conversion efficiency of 8.0%. The fluctuation of the output power was better than 2.3% in the given 30 min. The beam quality M2 factor value was equal to 1.15 at the maximum output power.

We have previously demonstrated that amniotic epithelial cells (AECs) can enhance survival and neural differentiation of neural stem cells (NSCs) when co-cultured in basal media. In addition, the presence of basic fibroblast growth factor (bFGF) enhances this AEC function. The aim of the present study was to extend those findings and investigate whether AECs modified with the bFGF gene will also enhance NSCs survival and neural differentiation in vivo and promote repair of the injured spinal cord. Female Wistar rats were used for a contusive spinal cord injury (SCI) model. Contusive SCIs were induced using a weight-drop device at levels T9-T11. Seven days following contusion, rats received grafts of NSCs only, NSCs with AECs/pLEGFP-hbFGF, or NSCs with AECs/pLEGFP-C1 into the injured region. Significant locomotor improvement was observed in the NSCs/AECs co-graft group beginning at 3 weeks compared with the NSCs or NaCl only groups. These results were confirmed and extended in an electrophysiological analysis. An immunohistological analysis revealed that AECs/pLEGFP-hbFGF promoted the survival (vs NaCl group: 194+/-9.17 vs 103.6+/-13.05) and neural differentiation (vs NaCl group: 14.24+/-1.11 vs 7+/-0.63) of co-transplanted NSCs. We also confirmed that AECs could promote the survival of host neurons. These results suggest that AECs/pLEGFP-hbFGF improve the NSCs survival and differentiation microenvironment and may be useful as a source of sustained trophic supported to improve NSCs differentiation into neurons in vivo. These findings suggest that a cograft of AECs/pLEGFP-hbFGF and NSCs may have benefits for SCI.

Amniotic epithelial cells (AECs) were reported to show a neuroprotective effect on neurons, but there was no direct evidence for a functional relationship between neural stem cells (NSCs) and AECs. The aim of this study was to determine whether AECs could stimulate differentiation and expand neurogenesis of NSCs, and whether the roles were due to a diffusible factor or required direct cell-cell contact. AECs were isolated from rat amnion on E14-16 and NSCs were isolated from neocortical tissue. The growth and differentiation of NSCs were compared under different conditions. The results showed that NSCs cultured with FGF-2 proliferated and formed floating neurospheres while those grown in B27 without FGF-2 failed to thrive. Those grown either with AEC conditioned medium or in transwells showed significantly improved survival. Moreover, the neural differentiation and length of neurite were greater in exogenous FGF groups when NSCs were allowed direct contact with AECs. Western blotting, immunocytochemistry and RT-PCR indicated that rat AECs could secrete NT-3 and BDNF. Furthermore, the presence of FGF-2 enhanced the function of AECs. These findings identified that AECs may be regarded as a critical component of NSCs niche and suggested that direct cell-to-cell contact may provide additional and independent support. Such information would circumvent the need for AECs-NSCs co-culture and could potentially facilitate the production of neurons for future clinical applications.

Our previous research has shown that seeding amniotic epithelial cells (AECs) in chemically extracted acellular muscle scaffold (CEAMC) better promotes the functional recovery of spinal cord injury (SCI) than scaffold alone. However, the massive death of transplanted cells, which is related to early inflammatory response, is still a problem in cell therapy. Our previous study proved that nordihydroguaiaretic acid (NDGA) inhibits inflammation after SCI. In this study, we tested a strategy of combining the early administration of NDGA and the transplantation of AEC-seeded CEAMC to treat SCI. The results showed that simply increasing the number of surviving AECs had no significant benefits in SCI therapy, but NDGA administration ameliorated transplanted AEC survival demonstrating the potential value of NDGA in the cellular transplantation treatment of SCI.

Electrochemical behavior of adrenaline at an electrode modified by carbon atom wires (CAWs), a new material, was investigated by cyclic voltammetry combined with UV–vis spectrometry, and forced convection method. As to the electrochemical response of redox of adrenaline/adrenalinequinone couple in 0.50 M H 2 SO 4 , at a nitric acid treated CAW modified electrode, the anodic and cathodic peak potentials E pa and E pc shifted by 87 mV negatively and 139 mV in the positive direction, respectively, and standard heterogeneous rate constant k 0 increased by 16 times compared to the corresponding bare electrode, indicating the extraordinary activity of CAWs in electrocatalysis for the process.

To determine dopamine (DA) in the presence of high concentration of ascorbic acid (AA), a glassy carbon electrode modified by carbon atom wires (CAWs), a kind of new homemade material, was investigated by cyclic voltammetry. It was found that the electrochemical responses of DA were affected by the presence of AA, the pH value of the electrolytic solution and an acid treated process on CAWs. The HNO 3 treated CAW modified electrode exhibited excellent ability to discriminate DA from AA by means of cyclic voltammetry and the separation of their anodic peak potentials was apart as wide as 0.298 V in pH 6.00 phosphate buffer solution containing 0.50 mM DA and 5.00 mM AA at the scan rate of 50 mV/s at the modified electrode.

A high-efficiency 1341 nm Nd:GdVO4 laser in-band pumped at 912 nm is demonstrated for the first time. Using an all-solid-state Nd:GdVO4 laser operating at 912 nm as pump source, 542 mW output was obtained with 1.14 W absorbed pump power. The slope efficiency with respect to the absorbed pump power was 56.6%, and the fluctuation of the output power was better than 2.6% in the given 30 min. The beam quality factor M 2 is 1.15.

Whether rapamycin has neuroprotective effects in spinal cord injury remains controversial. The present study shows that rapamycin protects neurons from death after spinal cord injury by inhibiting the secondary inflammatory response. The effects of rapamycin were tested using a myeloperoxidase assay, Western blotting, immunohistochemistry, and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The experimental results showed that after spinal cord injury, rapamycin reduced the numbers of activated microglia and neutrophils in the damage zone, lowered the expression levels of TNF-α and IL-1β, reduced the apoptotic cells, and increased the survival of neurons. The above data proved that rapamycin diminishes inflammatory cell activation and proliferation, downregulates the expression of inflammatory factors, reduces the microenvironmental damage effects on neurons in the acute injury phase, and thus promotes the survival of neurons. Therefore, we believe that rapamycin has neuroprotective effects in spinal cord injury.

Extracellular matrix is the gold standard for tissue regeneration. In this study, we directly made the extracellular matrix of the tissue or organ into scaffold for spinal cord injuries, a strategy that is seldomly tried in spinal cord engineering. The aim of this study was to determine if the chemically extracted acellular muscle could be a potential scaffold for spinal cord injury. The chemically extracted acellular muscle was implanted in the lateral hemisected adult rat thoracic spinal cord. Control rats were similarly injured. After 1 and 4 weeks, scaffold integration and biocompatibility, axon sprouting, and myelination were evaluated. The chemically extracted acellular muscle scaffolds were found to be well integrated with the host tissue. Sprouting axons grew into the full length of the scaffold in a strikingly parallel and linear fashion. A few remyelinated axons were also detected in the scaffolds. The tracing results in another six rats showed that labeled fibers entered the chemically treated muscle grafts. Furthermore, there were no apparent quantitative differences in the ED-1 and glial fibrillary acidic protein positive cells between groups. Neuron counting showed more surviving neurons in the acellular muscle treated group than those of the injured only group. Vascularization of the grafts was also confirmed. These findings clearly demonstrated that chemically extracted acellular muscle grafts provided useful biomatrices to enhance axon sprouting in the injured spinal cord.

To observe the effect of reperfusion therapy on the prognosis of acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) in reperfusion era.89 cases of AMI with CS were included with 57 male and 32 female. 50 cases received conservative therapy and 39 cases reperfusion therapy. 28 of the 39 cases had successful reperfusion and 11 cases failed. 18 patients had intra-aortic balloon pump (IABP) within 1 hour of CS, they constituted an early group; 35 patients treated with IABP 1 hour after CS were of a late group. A group of 36 cases were not treated with IABP (no IABP group).The mortality of the early group with IABP was significantly lower than that of the late and no IABP group (33.3% vs. 74.2% vs. 86.1%, P0.01). The mortality of the group with successful reperfusion was significantly lower than that of unsuccessful reperfusion and conservative no IABP group (42.8% vs. 81.8% vs. 84.0% , P0.01). logistic regression analysis showed that successful reperfusion therapy (OR 4.232, 95% CI 1. 07 - 12.730, P = 0.01) and THE TIME of using IABP (OR 0.22, 95% CI 0.063 - 0.764, P =0.017) were independent risk factors for death.Early successful reperfusion and early institution of IABP were the most important therapeutic measures for reducing mortality of AMI complicated by CS.

To construct rat Islet-1 gene recombinant retroviral expression vector and to transduce Islet-1 gene into neural stem cell (NSC) by the vector.The cDNA encoding the rat Islet-1 gene was isolated by RT-PCR method, the amplified gene fragment was subcloned into the retroviral vector plEGFP-C1. Islet-1 gene was transduced into NSC by PA317 packaging cells, then the expression of Islet-1 in NSC was observed.The recombinant Islet-1 retroviral vector was constructed successfully, as shown by PCR, restriction enzymes digestion and fluorescence detection, and the positive expression of Islet-1 was found in NSC by immunocytochemical staining. The variant of Islet-1 gene was also discovered in this study.The rat Islet-1 recombinant retroviral vector has been successfully prepared, which can be used to study the function of Islet-1 gene in NSC differentiation into cholinergic neurons.

The purpose of this study was to determine whether apoptosis in placenta was affected by IFNgamma, which can induce abortion, and whether the effect of IFNgamma on apoptosis resulted from an intrinsic program of apoptosis, which was regulated by Bcl-2 and Bax. DNA fragmentation analysis indicated that cleavage of DNA into 180 bp and its polymers were recognized in placenta in control and IFNgamma treated groups. Quantitative analysis of low molecular weight fragments of DNA revealed a significant increase in cases of 100,000 IU IFNgamma treatment compared with those in normal pregnancy (P

The unsteady cavitating turbulent flow in a Francis turbine is simulated based on governing equations of the mixture model for cavity-liquid two-phase flows with the RNG k- turbulence model in the present paper. An improved mass transfer expression in the mixture model is obtained based on evaporation and condensation mechanics with considering the effects of the non-dissolved gas, the turbulence, the tension of interface at cavity and the effect of phase change rate and so on. The governing equations of the mixture model for the unsteady cavitating-liquid flow is solved by a direct coupling method numerically with the finite volume method (FVM) using the unstructured tetrahedron grid and the structured hexahedral grid system. This direct coupling simulation was successfully applied to simulate the cavitating two-phase turbulent flow through a Francis turbine. The simulated external results agreed well with the experimental results.