Search

Background: Eustachian tube dysfunction (ETD) is a common otolaryngological disorder. The seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) was used for the assessment of symptoms related to ETD and treatment outcome. Currently, there is no traditional Chinese version of the ETDQ-7 to diagnose ETD in Taiwan. We aim to verify the reliability and validity of the traditional Chinese version of the ETDQ-7 in a clinical setting. Methods: The traditional Chinese version of the ETDQ-7 was completed by 60 adult subjects composed of 30 healthy controls and 30 subjects diagnosed with ETD. The internal consistency was evaluated using the Cronbach's α coefficient. The discriminant validity was calculated by receiver operating characteristic (ROC) curve as an accuracy measure. Results: The overall Cronbach's α coefficient of the traditional Chinese version ETDQ-7 was 0.717. The mean ETDQ-7 total score was 26.97 in the ETD group and 9.27 in the control group. The area under the ROC curve (AUC) was 99.8%, and the sensitivity and specificity of the traditional Chinese ETDQ-7 was 100% and 99.9%, respectively. Conclusion: The traditional Chinese version of the ETDQ-7 is a valid and reliable, disease-specific rating scale that can be used to quantitatively evaluate the severity of subjective symptoms of ETD in adult patients. Keywords: Eustachian tube, Eustachian tube dysfunction questionnaire-7, Questionnaire

Background/purpose: It was found that body temperature would be gradually increased during pediatric full mouth rehabilitation surgery. Although the etiology is unknown, here, we introduced an effective method to maintain normothermia during this kind of surgery. Materials and methods: Following IRB approval, the medical records of pediatric patients who received full mouth rehabilitation surgery from Jan. 2014 through Jun. 2016 were collected. All the patients included were managed by a “tent-like draping” with a forced-air warmer (Life-Air 1000, Progressive Dynamics Inc.). The temperature of the forced-air was changed from 38 °C to cool ambient temperature when the body temperature higher than 36 °C. The body temperatures (preoperative, periodic during operation, and postoperative) and the maximum body temperature changes during operation were recorded. The data was compared with the results of a previous report. Results: Total 37 patients were enrolled. The maximum temperature change during operation was 2.08 ± 0.6 °C. The incidence of body temperature higher than 37.5 °C during operation was 10.8% (4/37). Compare to the previous report in which the patients received the same operation with ordinary surgical draping, the maximum temperature change and the incidence of body temperature higher than 37.5 °C during operation were significantly lower in patients received “tent-like draping” (2.08 ± 0.64 °C vs 2.50 ± 1.17 °C, p

During general anesthesia, anesthesiologists encounter problems including difficult airway intubation, high respiratory airway pressure, fluctuation of blood pressure, and poor oxygen saturation, especially in obese patients. In addition, obese patients with asthma or bronchospasm make these difficulties even more challenging. We present the case of a 37-year-old male with morbid obesity (height: 160 cm, weight: 120 kg, and body mass index: 47 kg/m[2]) with asthma attack and who was injured during a car accident that caused open fracture of the right patella which needed emergent open reduction and internal fixation surgery. He refused spinal anesthesia. By using rocuronium and its reversal agents sugammadex, lidocaine, β-2 agonist, epinephrine, sevoflurane, hydrocortisone, magnesium sulfate, and deep extubation, we were able to intubate smoothly and extubate successfully after the surgery without intensive care.

Background: Oxytocin is commonly used to reduce blood loss during suction curettage for missed abortion. However, the potential of oxytocin to mitigate blood loss in early pregnancy remains controversial. Based on the hypothesis that the "timing" of oxytocin administration may be a critical factor, we investigated whether the timing of intravenous (IV) administration is associated with reduced perioperative blood loss during first-trimester suction curettage for missed abortion. Methods: The medical charts of 146 patients with ultrasound-confirmed first-trimester missed abortion who underwent suction curettage with IV oxytocin administration were retrospectively reviewed. Results: Among the patients, 67 received 10 IU of IV oxytocin before suction curettage (early-oxytocin administration group), while 79 patients received 10 IU of IV oxytocin after suction curettage (late-oxytocin administration group). The demographic features between the two groups did not significantly differ. However, there was a lower proportion of nulliparous patients in the early-oxytocin administration group than in the late-oxytocin administration group (38.8% vs 60.8%, p = 0.006). The perioperative blood loss amount was significantly lower in the early-oxytocin administration group than in the late-oxytocin administration group (60 [range: 50-100] vs 100 [range: 30-250] mL, p = 0.001). Moreover, the multivariate logistic regression analysis showed that the early-oxytocin administration group had a lower risk for a perioperative blood loss amount of >100 mL than the late-oxytocin administration group (0.23 [range: 0.10-0.55], p = 0.001); a gestational age of 9-12 weeks (p = 0.009) was found to be associated with an increased risk for a perioperative blood loss amount of ≥100 mL. Conclusion: Compared with late-oxytocin administration, early-oxytocin administration could reduce perioperative blood loss during first-trimester suction curettage for missed abortion. However, the results require further investigation. [ABSTRACT FROM AUTHOR]

Background: Open living donor hepatectomy (OLDH) is a highly painful procedure. Advanced strategies for enhancing perioperative analgesia and accelerating recovery are needed for patients undergoing OLDH. This study evaluated the effects of intravenous infusion of dexmedetomidine (DEX) during OLDH on postoperative analgesia and recovery. Methods: This prospective, randomised, double-blinded, and placebo-controlled study included 34 patients randomised to a control group (group C) and a DEX group (group D). Utilisation of intravenous patient-controlled analgesia (IV-PCA) pump, pain intensity, and postoperative recovery variables were recorded. Moreover, intraoperative anaesthetic consumption, hemodynamic parameters, and fluid status were also recorded. Results: During the first 24 hours after surgery, patients in group D had a lower pain intensity. The cumulative numbers of IV-PCA pump presses and fentanyl consumption within 24 and 48 hours postoperatively in group C were significantly higher than in group D. The time to first IV-PCA attempt was prolonged in group D. In addition, faster flatus passage was observed in group D. Intraoperatively, fewer anaesthetic agents were required in group D. Less fluctuation in hemodynamics and reduced bleeding were also found in group D. Conclusions: The present study revealed that the addition of intravenous infusion of DEX during OLDH provided several benefits in relieving postoperative pain and promoting recovery. Therefore, we concluded that intraoperative DEX infusion may play an important role in enhancing the recovery of patients undergoing OLDH. [ABSTRACT FROM AUTHOR]

Critical cases of coronavirus disease 2019 (COVID‐19) are associated with a high risk of mortality. It remains unclear why patients with the same critical condition have different outcomes. We aimed to explore relevant factors that may affect the prognosis of critical COVID‐19 patients. Six critical COVID‐19 inpatients were included in our study. The six patients were divided into two groups based on whether they had a good or poor prognosis. We collected peripheral blood samples at admission and the time point of exacerbation to compare differences in the phenotypes and functions of major populations of immune cells between the groups. On admission, compared to patients with poor prognoses, those with good prognoses had significantly higher counts of monocytes (P <.05), macrophages (P <.05), higher frequency of CD3+CD4+CD45RO+CXCR3+ subsets (P <.05), higher frequency of CD14+CD11C+HLA‐DR+ subset of dendritic cells (P <.05), and a lower count of neutrophils (P <.05). At the time point of exacerbation, the proportions of naïve CD4+ T cells (P <.05), Tregs, and Th2 cells in the poor prognosis group were relatively higher than those in the good prognosis group, and CD4+ memory T cells were relatively lower (P <.05). According to our results, the poor prognosis group showed a worse immune response than the good prognosis group at the time of admission and at exacerbation. Dysregulation of the immune response affects the outcome of critical COVID‐19 patients. Highlights: The pathogenesis of COVID‐19 is not fully known.COVID‐19 patients with the same critical condition had different outcomes.Immune response plays an important role in defensing against virus infections. [ABSTRACT FROM AUTHOR]

A theoretical study on the structural dynamics of the temporal behavior of Bragg diffraction is presented and compared with experimental results obtained via ultrafast electron crystallography. In order to describe the time-dependent lattices and calculate the Bragg diffraction intensity, we introduce the basic vector offset matrix, which can be used to quantify the shortening, lengthening and rotation of the three lattice vectors (i.e., lattice deformation). Extensive simulations are performed to evaluate the four-dimensional electron crystallography model. The results elucidate the connection between structural deformations and changes in diffraction peaks, and sheds light on the quantitative analysis and comprehensive understanding of the structural dynamics. [ABSTRACT FROM AUTHOR]

Fibrocytes are myeloid lineage cells implicated in wound healing, repair, and fibrosis. We previously showed that fibrocytes are mobilized into the circulation after vascular injury, including the immune-mediated injury that occurs after allogeneic transplantation. A common response to inflammatory vascular injury is intimal hyperplasia (IH), which, alongside vascular remodeling, results in progressive loss of blood flow, downstream ischemia, and end-organ fibrosis. This forms the pathological basis of transplant arteriosclerosis and other diseases including post-angioplasty re-stenosis. In investigating whether fibrocytes contribute to IH, we previously showed that subpopulations expressing smooth muscle actin and CD31 are recruited to the site of injury and accumulate in the neointima. Expression of tissue factor (TF) by these “CD31+ myofibrocytes” is needed for progressive neointimal expansion, such that TF inhibition limits the neointima to a single layer of cells by day 28 post-injury. The aim of this study was to determine pathophysiological mediators downstream of TF that contribute to myofibrocyte-orchestrated IH. We first show that myofibrocytes make up a significant component of the neointima 28 days following injury. Using a previously defined adoptive transfer model, we then show that CD31+ myofibrocytes get recruited early to the site of injury; this model allows manipulations of the adoptively transferred cells to study how IH develops. Having confirmed that inhibition of TF on adoptively transferred cells prevents IH, we then show that TF, primarily through the generation of thrombin, induces secretion of angiopoietin-2 by myofibrocytes and this directly stimulates proliferation, inhibits apoptosis, and induces CXCL-12 production by neointimal cells, including non-fibrocytes, all of which promote progressive IH in vivo. Prior incubation to inhibit angiopoietin-2 secretion by or block TIE-2 signaling on adoptively transferred fibrocytes inhibits IH. These novel data indicate that angiopoietin-2 production by early recruited myofibrocytes critically influences the development of IH after vascular injury and suggest new therapeutic avenues for exploration. [ABSTRACT FROM AUTHOR]

The insecticidal activity of Illicium verum Hook. f. against Sitophilus zeamais Motschulsky adults were identified, and the underlying mechanisms were studied. Extracts from I.verum fruits in methyl alcohol (MA), ethyl acetate (EA), and petroleum ether (PE) were tested by fumigation in a hermetic container to determine their toxicity. The effects of the three extracts on the activity of acetylcholinesterase (AChE) and glutathione S-transferases (GSTs) of S. zeamais were determined in vivo. All extracts showed strong fumigant activity. The fumigant effects were enhanced with increased dosage and prolonged exposure time. 1.25, 2.50, 5.00, 10.00, and 20.0 mg/l doses of the MA, EA, and PE extracts caused the mortalities from 8.37 to 90.26 %, 21.81 to 95.89 %, and 15.84 to 92.57 %, respectively, at 72 h after treatment. Consequently, the most effective dose of the MA, EA, and PE extracts is the 20.0 mg/l. The LD 50 of the MA, EA, and PE extracts at 72 h after treatment were 7.10, 3.93, and 4.55 mg/l, respectively. The activities of AChE and GSTs were notably inhibited by the three extracts, as compared with the control, with strong dose- and time-dependent effects. The inhibition strength of the three extracts on AChE and GSTs activities were in the following order: EA extract > PE extract ≥ MA extract. Therefore, I. verum extracts could be explored as novel natural fumigants for the future control of stored-product insect pests. [ABSTRACT FROM AUTHOR]

Calcineurin (CN) is the common receptor for two immunophilin-immunosuppressant complexes, Cyp-CsA and FKBP-FK506. Calcineurin is composed of a catalytic subunit (CNA) and a regulatory subunit (CNB). CNA contains the catalytic domain and three regulatory domains: a CNB-binding domain (BBH, 350 - 370), a calmodulin- binding domain (CBD, 389 - 413), and an autoinhibitory domain (AID, 457 - 482). To investigate the effects of these three regulatory domains on the inhibition of CN by the two drugs we constructed three C-terminal deletion mutants: CNAabc (1 - 456), CNAab (1 - 388) and CNAa (1 - 347). Inhibition of CNA and its derivatives by the two drugs was examined and compared with inhibition by peptides (AID [457 - 482] and LCBD [389 - 456], CBD and the extension of the AID were included). Our results show that the BBH is critical for inhibition of CN by Cyp-CsA and FKBP-FK506. The LCBD has no effect and the AID reduces the inhibition of CN by two complexes. In addition, LCBD and AID as autoinhibitors may inhibit enzyme activity via different sites. IUBMB Life, 59: 388 - 393, 2007 [ABSTRACT FROM AUTHOR]

To date, there are some chemically synthesized curcumin derivatives which were produced and identified to evade the disadvantages of physiochemical stability and solubility of curcumin. Here, one novel curcumin derivative, (2‐(3‐{(1E)‐{(E)‐3‐(4‐hydroxy‐3‐methoxybenzylidene)‐2‐oxocyclohexylidene)methyl)‐1H‐indol‐1‐yl)acetic acid}, (abbreviated as MOMI‐1) was first used to detect the antiproliferation activity with MTT assays in different cancer cells including A549 lung cancer cells, MCF‐7, and HEPG2 cell lines, and exhibited its wide inhibition spectrum. Next, we found that MOMI‐1 could induce autophagic genesis of A549 cells by acridine orange or monodansylcadaverine (MDC) staining and green fluorescent protein‐light chain 3 (GFP‐LC3) recombinant plasmid transfection analysis, respectively. Western blot analysis confirmed the LC3‐I/II conversion, beclin‐1 increase and p62 reduction of A549 cells after exposure of MOMI‐1, which suggested the typical autophagy induction. The following cell cycle test showed that MOMI‐1 could block A549 cells in G0/G1 phase. Furthermore, wounding healing experiment and transwell assays demonstrated that MOMI‐1 also possessed the antimigration ability of A549 cells. Our current results confirmed that MOMI‐1 could inhibit the proliferation and induce autophagy of A549 cells, which provide a new potential chemical candidate of antigrowth of A549 lung cancer cells. Future work needs to focus on the mechanism of autophagy pathway of A549 cells. [ABSTRACT FROM AUTHOR]

High-temperature superconductivity is often found in the vicinity of antiferromagnetism. This is also true in LaFeAsO1−xFx (x ≤ 0.2) and many other iron-based superconductors, which leads to proposals that superconductivity is mediated by fluctuations associated with the nearby magnetism. Here we report the discovery of a new superconductivity dome without low-energy magnetic fluctuations in LaFeAsO1−xFx with 0.25 ≤ x ≤ 0.75, where the maximal critical temperature Tc at xopt = 0.5−0.55 is even higher than that at x ≤ 0.2. By nuclear magnetic resonance and transmission electron microscopy, we show that a C4 rotation symmetry-breaking structural transition takes place for x > 0.5 above Tc. Our results point to a new paradigm of high temperature superconductivity. [ABSTRACT FROM AUTHOR]

Background: The intimal hyperplasia (IH) and vascular remodelling that follows endovascular injury, for instance after post-angioplasty re-stenosis, results in downstream ischaemia and progressive end organ damage. Interferon gamma (IFNγ) is known to play a critical role in this process. In mouse models we have previously shown that fibrocytes expressing tissue factor (TF) are recruited early to the site of injury. Through thrombin generation and protease activated receptor-1 (PAR-1) activation, fibrocytes secrete angiopoietin-2, stimulate neointimal cell proliferation, inhibit apoptosis and induce CXCL-12 production, all of which contribute to the progressive IH that then develops. In this study we investigated the relationship between TF, angiopoietin-2 and IFNγ., Methods and Results: IH developing in carotid arteries of wild-type mice 4 weeks after endoluminal injury contained a significant proportion of IFNγ+ fibrocytes and macrophages, which we show, using a previously defined adoptive transfer model, were derived from circulating CD34+ cells. IH did not develop after injury in IFNγ-deficient mice, except after transplantation of WT bone marrow or adoptive transfer of WT CD34+ cells. In vitro , CD34+ cells isolated from post-injury mice did not express IFNγ, but this was induced when provided with FVIIa and FX, and enhanced when prothrombin was also provided: In both cases IFNγ secretion was TF-dependent and mediated mainly through protease activated PAR-1. IFNγ was predominantly expressed by fibrocytes. In vivo , all IFNγ+ neointimal cells in WT mice co-expressed angiopoietin-2, as did the small numbers of neointimal cells recruited in IFNγ-/- mice. Adoptively transferred WT CD34+ cells treated with either an anti-TIE-2 antibody, or with siRNA against angiopoetin-2 inhibited the expression of IFNγ and the development of IH., Conclusion: TF-dependent angiopoietin-2 production by newly recruited fibrocytes, and to a lesser extent macrophages, switches on IFNγ expression, and this is necessary for the IH to develop. These novel findings enhance our understanding of the pathophysiology of IH and expose potential targets for therapeutic intervention., Competing Interests: JM was employed by University of Surrey at the time this work was performed, but is now employed by Coagulare Biomedica Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Li, Wei, Ma, McVey and Dorling.)

The Minisci-type dehydrogenative coupling of N-heteroaromatic rings with inert C-H or Si-H partners via visible-light-catalyzed hydrogen atom transfer has been reported. This methodology allows the coupling reactions to be carried out in water as a solvent under air atmospheric conditions with visible-light illumination. A wide range of inert C-H and Si-H partners could be directly coupled with various N-aromatic heterocycles to deliver products in good to excellent yields.

The perinuclear theca (PT) is a cytoskeletal element encapsulating the sperm nucleus; however, the physiological roles of the PT in sperm are largely uncertain. Here, we reveal that ACTRT1, ACTRT2, ACTL7A and ACTL9 proteins interact to form a multimeric complex and localize to the subacrosomal region of spermatids. Furthermore, we engineered Actrt1-knockout (KO) mice to define the functions of ACTRT1. Despite normal sperm count and motility, Actrt1-KO males were severely subfertile owing to a deficiency in fertilization. Loss of ACTRT1 caused a high incidence of malformed heads and detachment of acrosomes from sperm nuclei, caused by loosened acroplaxome structure during spermiogenesis. Furthermore, Actrt1-KO sperm showed reduced ACTL7A and PLCζ protein content as a potential cause of fertilization defects. Moreover, we reveal that ACTRT1 anchors developing acrosomes to the nucleus, likely by interacting with the inner acrosomal membrane protein SPACA1 and the nuclear envelope proteins PARP11 and SPATA46. Loss of ACTRT1 weakened the interaction between ACTL7A and SPACA1. Our study and recent findings of ACTL7A/ACTL9-deficient sperm together reveal that the sperm PT-specific ARP complex mediates the acrosome-nucleus connection., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2022. Published by The Company of Biologists Ltd.)

Background Anticoagulants induce atherosclerosis regression in animal models but exploiting this clinically is limited by bleeding events. Here we test a novel thrombin inhibitor, PTL060, comprising hirulog covalently linked to a synthetic myristoyl electrostatic switch to tether to cell membranes. Methods and Results ApoE-/- mice were fed chow or high-fat diets, before transplantation of congenic aortic segments or injection of PTL060, parental hirulog, control saline, or labeled CD11b positive cells. Aortic transplants from transgenic mice expressing anticoagulants on endothelium did not develop atherosclerosis. A single intravenous injection of PTL060, but not hirulog inhibited atheroma development by >50% compared with controls when assessed 4 weeks later. Mice had prolonged bleeding times for only one seventh of the time that PTL060 was biologically active. Repeated weekly injections of PTL060 but not hirulog caused regression of atheroma. We dissected 2 contributory mechanisms. First, the majority of CCR2+ (C-C chemokine receptor type 2+) monocytes recruited into plaques expressed CCR7 (C-C chemokine receptor type 7), ABCA1 (ATP-binding cassette transporter - 1), and interleukin-10 in PTL060 mice, a phenotype seen in <20% of CCR2+ recruits in controls. Second, after several doses, there was a significant reduction in monocyte recruits, the majority of which were CCR2-negative with a similar regression-associated phenotype. Regression equivalent to that induced by intravenous PTL060 was induced by adoptive transfer of CD11b+ cells pre-coated with PTL060. Conclusions Covalent linkage of a myristoyl electrostatic switch onto hirulog in PTL060 uncouples the pharmacodynamic effects on hemostasis and atherosclerosis, such that plaque regression, mediated predominantly via effects on monocytes, is accompanied by only transient anticoagulation.

Objective: This study was to explore the correlation between the standardized uptake value (SUV) of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) imaging and the apparent diffusion coefficient (ADC) value of magnetic resonance imaging (MRI) to the pathological features of cervical cancer (CC)., Subjects and Methods: The maximum and mean SUV of 18 F-FDG PET/CT (SUVmax and SUVmean) and the minimum ADC (ADCmin) were collected from 72 patients with CC. The correlation between SUVmax and ADCmin was also assessed. Furthermore, the relationship between SUVmax, SUVmin, ADCmin and the clinical pathological characteristics of CC was analyzed., Results: A significant increase in the SUVmax was observed in the group of CC cases with lymph node metastases and in the group with distant metastases compared to those without metastases (F=6.782, P=0.002; F=4.483, P=0.015). Furthermore, in the low differentiation groups compared to high/middle differentiation groups (F=3.342,P=0.024), in the squamocellular carcinoma groups compared to the adenocarcinoma and adenosquamous carcinoma groups (F=3.295, P=0.026) and finally in the International Federation of Gynecology and Obstetrics (FIGO) stage III-IV groups compared with stage III-IV groups (F=3.123, P=0.020).The SUVmean values of the lymph node metastases and distant metastases groups were significantly higher than those without lymph node metastases (F=5.802, P=0.005; F=3.486, P=0.036). We saw no correlation between the ADCmin and lymph node metastases. The SUVmax value had weak correlation with the ADCmin (r=-0.306, P=0.036). The SUVmax is most closely related to the clinical pathological characteristics of CC., Conclusion: An increased SUVmax suggests lymph node metastases or distant metastases, low differentiation and FIGO stage III-IV. A low negative correlation was observed between the SUVmax and ADCmin, while we observed no correlation between the ADCmin and the clinical pathological characteristics of cervical cancer.

C5a receptor 1 (C5aR1) is a G protein-coupled receptor for C5a and also an N-linked glycosylated protein. In addition to myeloid cells, C5aR1 is expressed on epithelial cells. In this study, we examined the role of C5aR1 in bacterial adhesion/colonization of renal tubular epithelium and addressed the underlying mechanisms of this role. We show that acute kidney infection was significantly reduced in mice with genetic deletion or through pharmacologic inhibition of C5aR1 following bladder inoculation with uropathogenic E. coli (UPEC). This was associated with reduced expression of terminal α-mannosyl residues (Man; a ligand for type 1 fimbriae of E. coli) on the luminal surface of renal tubular epithelium and reduction of early UPEC colonization in these mice. Confocal microscopy demonstrated that UPEC bind to Man on the luminal surface of renal tubular epithelium. In vitro analyses showed that C5a stimulation enhances Man expression in renal tubular epithelial cells and subsequent bacterial adhesion, which, at least in part, is dependent on TNF-α driven by C5aR1-mediated intracellular signaling. Our findings demonstrate a previously unknown pathogenic role for C5aR1 in acute pyelonephritis, proposing a potentially novel mechanism by which C5a/C5aR1 signaling mediates upregulation of carbohydrate ligands on renal tubules to facilitate UPEC adhesion.

The potent anti-hyperuricemia activities of Fructus Gardenia Extract (FGE) have been well reported. The aim of this study was to evaluate the uricosuric and nephro-protective effects of FGE and explore its possible mechanisms of action in oxonate-induced hyperuricemic mice. FGE was orally administered to hyperuricemic and normal mice for 1 week. Serum and urinary levels of uric acid, creatinine and blood urea nitrogen (BUN), and fractional excretion of uric acid (FEUA) were measured. The mRNA and protein levels of mouse urate transporter 1 (mURAT1), glucose transporter 9 (mGLUT9), ATP-binding cassette, subfamily G, 2 (mABCG2), organic anion transporter 1 (mOAT1), mOAT3, oncoprotein induced transcript 3 (mOIT3), organic cation/carnitine transporters in the kidney were analyzed. Simultaneously, Tamm-Horsfall glycoprotein (THP) levels in urine and kidney were detected. FGE significantly reduced serum urate levels and increased urinary urate levels and FEUA in hyperuricemic mice. It could also effectively reverse oxonate-induced alterations in renal mURAT1, mGLUT9, mOAT1 and mOIT3 expressions, as well as THP levels, resulting in the enhancement of renal uric acid excretion. Moreover, FGE decreased serum creatinine and BUN levels, and up-regulated expression of organic cation/carnitine transporters, improving renal dysfunction in this model. Furthermore, FGE decreased renal mABCG2 expressions in hyperuricemic mice, contributing to its beneficial actions. However, further investigation is needed in clinical trials of FGE and its bioactive components.

Aim: To compares the clinical features of patients infected with hepatitis E virus (HEV) with or without severe jaundice. In addition, the risk factors for HEV infection with severe jaundice were investigated., Methods: We enrolled 235 patients with HEV into a cross-sectional study using multi-stage sampling to select the study group. Patients with possible acute hepatitis E showing elevated liver enzyme levels were screened for HEV infection using serologic and molecular tools.HEV infection was documented by HEV antibodies and by the detection of HEV-RNA in serum. We used χ(2) analysis, Fisher's exact test, and Student's t test where appropriate in this study. Significant predictors in the univariate analysis were then included in a forward, stepwise multiple logistic regression model., Results: No significant differences in symptoms, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, or hepatitis B virus surface antigen between the two groups were observed. HEV infected patients with severe jaundice had significantly lower peak serum levels of γ-glutamyl-transpeptidase (GGT) (median: 170.31 U/L vs 237.96 U/L, P = 0.007), significantly lower ALB levels (33.84 g/L vs 36.89 g/L, P = 0.000), significantly lower acetylcholine esterase (CHE) levels (4500.93 U/L vs 5815.28 U/L, P = 0.000) and significantly higher total bile acid (TBA) levels (275.56 μmol/L vs 147.03 μmol/L, P = 0.000) than those without severe jaundice. The median of the lowest point time tended to be lower in patients with severe jaundice (81.64% vs 96.12%, P = 0.000). HEV infected patients with severe jaundice had a significantly higher viral load (median: 134 vs 112, P = 0.025) than those without severe jaundice. HEV infected patients with severe jaundice showed a trend toward longer median hospital stay (38.17 d vs 18.36 d, P = 0.073). Multivariate logistic regression indicated that there were significant differences in age, sex, viral load, GGT, albumin, TBA, CHE, prothrombin index, alcohol overconsumption, and duration of admission between patients infected with acute hepatitis E with and without severe jaundice., Conclusion: Acute hepatitis E patients may naturally present with severe jaundice.

Purpose: To compare fatigue experiences and related factors during the first 6 weeks of stereotactic radiotherapy (SRT) for liver cancer patients with and without fatigue before SRT., Patients and Methods: Subjects (n = 91) were liver cancer patients receiving SRT at two teaching hospitals in northern Taiwan. Data were collected at seven times: the week before SRT (T0) and the end of each of the first 6 weeks of SRT (T1, T2, T3, T4, T5, and T6). Study variables were fatigue intensity, fatigue interference (with patients' daily life), functional status, symptom distress, sleep disturbance, depressive status, radiation dose, stage of cancer, and selected laboratory data., Results: Subjects were divided at T0 into two groups by fatigue level: those without (group 1, n = 32) and with (group 2, n = 59) pretreatment fatigue distress. Patients in group 2 had higher levels of fatigue intensity and interference than did patients in group 1. Both groups had similar patterns of fatigue interference, peaking at T5. However, patterns of average fatigue intensity differed slightly. In group 2, fatigue intensity remained constant until T3 and then increased to a peak at T5. In group 1, fatigue intensity increased to a peak between T4 and T5. Generalized estimating equation analysis showed significant differences between groups in fatigue intensity and interference across 6 weeks. Examination of factors related to fatigue after SRT indicated that sleep disturbance significantly predicted both fatigue intensity and interference in group 1, but depressive status, overall symptom distress, and education level predicted fatigue intensity and interference for group 2., Conclusion: Liver cancer patients with or without fatigue before treatment had different fatigue experiences across 6 weeks of radiation therapy. Fatigue experiences of liver cancer patients receiving SRT can be better understood through future studies exploring patients' long-term fatigue changes and responses to fatigue-management interventions.