Search

The paper documents on the uses of traditional medicinal plants used for treating human ailments in three villages of Ledong, a county inhabited by Li ethnic group in the southwest of Hainan Province, China. Semi-structured interviews, key informant interviews and participatory observations were used to collect ethnobotanical data from February to March 2012 and in July 2013. The data collected was analyzed using descriptive statistics. Thirty native knowledgeable people were interviewed. The Li community uses 50 plant species in 36 families for medicinal purposes. The most common medicinal plant families were Leguminosae (14%), Compositae (6%), and Euphorbiaceae (6%), and the most common preparations methods were decoction (84%), crushing (38%), and poultice (34%). The traditional medicinal plants were mainly used for hemostasis (12.9%), body pains (11.4%), gastrointestinal disorders (11.4%), and trauma (10%). Twenty-four species of medicinal plants (48%) have never been reported in the literature of Li medicines. In addition, 22 species (44%) have already been studied by researchers and their extracts or compounds were good bio-actives. However, the rapid socio-economic development in the county is the main threat to the conservation of Li medicine and has resulted in the decrease in the abundance and use of medicinal plants and associated traditional knowledge. Other factors accounting for a decrease in the use of Li medicinal plants like loss of plant diversity, change of land use, and threatened traditional knowledge were equally discussed.

Recent studies showed that cyclophilin A (CypA) promotes NF-κB/p65 nuclear translocation, resulting in enhanced NF-κB activity and altered expression of its target genes, such as the Sox9 transcriptional factor, which plays a critical role in chondrogenic differentiation and endochondral ossification. In this report, we unveil the role of CypA in signal-induced chondrogenic differentiation and endochondral ossification. Expression levels of the chondrogenic differentiation markers and transcriptional regulators Sox9 and Runx2 were all significantly lower in CypA knockdown chondrogenic cells than in wild-type cells, indicating that CypA plays a functional role in chondrogenic differentiation. In vitro differentiation studies using micromass cultures of mouse limb bud cells further supported the conclusion that CypA is needed for chondrogenic differentiation. Newborn CypA-deficient pups double stained with alcian blue and alizarin red exhibited generalized, pronounced skeletal defects, while high-resolution micro-computed tomography (microCT) analyses of the femurs and lumbar vertebrae revealed delayed or incomplete endochondral ossification. Comparative histology and immunohistochemistry (IHC) analyses further verified the effects of CypA deficiency on chondrogenic differentiation. Our results provide evidence for the important contribution of CypA as a pertinent component acting through NF-κB-Sox9 in regulation of chondrogenesis signaling. These findings are important to better understand signal-induced chondrogenesis of chondrogenic progenitors in physiological and pathophysiological contexts.

Background/Purpose: To develop a prediction model for emergency medical technicians (EMTs) to identify trauma patients at high risk of deterioration to emergency medical service (EMS)-witnessed traumatic cardiac arrest (TCA) on the scene or en route. Methods: We developed a prediction model using the classical cross-validation method from the Pan-Asia Trauma Outcomes Study (PATOS) database from 1 January 2015 to 31 December 2020. Eligible patients aged ≥18 years were transported to the hospital by the EMS. The primary outcome (EMS-witnessed TCA) was defined based on changes in vital signs measured on the scene or en route. We included variables that were immediately measurable as potential predictors when EMTs arrived. An integer point value system was built using multivariable logistic regression. The area under the receiver operating characteristic (AUROC) curve and Hosmer-Lemeshow (HL) test were used to examine discrimination and calibration in the derivation and validation cohorts. Results: In total, 74,844 patients were eligible for database review. The model comprised five prehospital predictors: age 20/minute, pulse oximetry

Abstract Background Plant-based diets offer more beneficial microbes and can modulate gut microbiomes to improve human health. We evaluated the effects of the plant-based OsomeFood Clean Label meal range (‘AWE’ diet), on the human gut microbiome. Methods Over 21 days, ten healthy participants consumed OsomeFood meals for five consecutive weekday lunches and dinners and resumed their regular diets for other days/meals. On follow-up days, participants completed questionnaires to record satiety, energy and health, and provided stool samples. To document microbiome variations and identify associations, species and functional pathway annotations were analyzed by shotgun sequencing. Shannon diversity and regular diet calorie intake subsets were also assessed. Results Overweight participants gained more species and functional pathway diversity than normal BMI participants. Nineteen disease-associated species were suppressed in moderate-responders without gaining diversity, and in strong-responders with diversity gains along with health-associated species. All participants reported improved short-chain fatty acids production, insulin and γ-aminobutyric acid signaling. Moreover, fullness correlated positively with Bacteroides eggerthii; energetic status with B. uniformis, B. longum, Phascolarctobacterium succinatutens, and Eubacterium eligens; healthy status with Faecalibacterium prausnitzii, Prevotella CAG 5226, Roseburia hominis, and Roseburia sp. CAG 182; and overall response with E. eligens and Corprococcus eutactus. Fiber consumption was negatively associated with pathogenic species. Conclusion Although the AWE diet was consumed for only five days a week, all participants, especially overweight ones, experienced improved fullness, health status, energy and overall responses. The AWE diet benefits all individuals, especially those of higher BMI or low-fiber consumption.

Abstract: Migration remains a natural human phenomenon. Humans have always moved from one place to the other. People have always migrated internally (national) and externally (international). From a post-colonial approach, this paper focuses on international migration and aims to analyse the ideological construction of this phenomenon in two Cameroonian novels- From Dust to Snow: Bush-faller by Lydia and Wilfred Ngwa and Snare by Priscillia Musoh Manjoh. The findings show that migrants and aspiring migrants have some constructed ideas when it comes to international migration. To them, international migration is perceived as a quest for a better life and a means to upgrade families’ standards of living, the search for employment, a risk bearing phenomenon and a source of remittances flow to families back in migrants’ countries of origin. Keywords: Ideological construction, migration, international migration, success, employment

Background and Aim: Healthcare students highly affect the general public regarding transferring knowledge about novel therapeutic approaches. Therefore, assessing and updating their knowledge about the application of new strategies in the treatment of different diseases is very important. The present study was designed to evaluate the level of the students’ knowledge about stem cells and their application in neurological disorders at the Guilan University of Medical Sciences (GUMS). Methods and Materials/Patients: In this cross-sectional study, a questionnaire was designed in three sections. Exclusion criteria were reluctance to participate in the project or answer to less than 20% of the questions. Inclusion criteria included studying at GUMS and willingness to participate in the project and answer the questionnaire. The questionnaire was distributed in all GUMS faculties, including medicine, paramedicine, nursing and midwifery, dentistry, health, and pharmacy. The data were analyzed by SPSS v. 16 through Pearson correlation coefficient, independent t-test, oneway analysis of variance (ANOVA), and Cronbach’s alpha. Results: According to the total awareness score, 51.2% of students showed very poor and 39.7% showed poor knowledge about stem cells and their application in neurological diseases. The knowledge score of the students in the medical faculty was higher than non-medical and was dependent on their educational year. In addition, medical students showed no significant difference in neither knowledge (F=1.406, P=0.221) nor attitude (F=0.603, P=0.697) scores. Fortunately, 72.2% of students had moderate and 20.6% had a strong attitude toward stem cell applications. A moderate correlation was observed between attitude toward stem cells and knowledge about the application of stem cells (r=0.325, P=0.000). Conclusion: GUMS students’ knowledge level was poor toward stem cells and their application in neurological diseases. It is suggested to include some courses about stem cells in the educational curriculum. However, the student’s attitude toward the use of stem cells was encouraging.

Explores the plausibility of integrating solid modelers in an electromagnetic device design environment. Experience gained in interfacing a commercial solid modeler with established field codes; Overview of solid modeling techniques; Advantages and disadvantages of using a separate solid modeler.

Aims: This study explored gender differences in life stressors of children and adolescents who died by suicide. Three main classes of life stressors have been identified by previous research to be significant risk factors for suicide in children and adolescents: interpersonal/relationship problems, family problems, and academic/school problems. Methods: The sample consisted of 156 (89 males and 67 females) completed child and adolescent suicides in Singapore from 1995 to 2003. The age of these individuals ranged from 10 to 19 years with a mean age of 16.49 (SD = 2.59). Results: Significantly more females were found to have had interpersonal/ relationship problems as recent life stressors compared with males. No gender differences were found for the other two life stressors, family problems and academic/school problems. In addition, among the three life stressors studied, only interpersonal/relationship problems emerged as a significant predictor of female child and adolescent suicide. Conclusions: Consistent with previous research literature, these findings contribute to a growing literature documenting the relatively larger impact of relational life stressors on child and adolescent female suicidality. Implications for suicide intervention and prevention, especially among young females, were discussed. [ABSTRACT FROM AUTHOR]

The association of coronary artery spasm and myocardial bridging is very uncommon and may represent a distinct clinical entity. Three patients are described, presenting with acute coronary syndrome associated with myocardial bridging and coronary artery spasm. The relationship and respective roles of myocardial bridging and spasm, however, remain uncertain and may be consequent to a direct effect on endothelial function from the compressive effect of myocardial bridging. The role of intracoronary nitroglycerin in these patients is unresolved. [ABSTRACT FROM AUTHOR]

Diffuse conduction abnormalities in an adolescent with familial sinus node disease, We report a case of familial sinus node disease with associated conduction abnormalities in the atrioventricular node and distal conducting system. Spontaneous atrial pacemaker activity was absent though the atrium could be depolarized. The pacemaker activity of the heart resided in the atrioventricular junction. The AV node showed impaired automaticity and abnormal conduction properties which partially improved after vagal blockade. [ABSTRACT FROM AUTHOR]

A 50 year-old woman with recurrent palpitations presented with electrocardiographic changes of simultaneous type A and type B Wolff-Parkinson-White conduction abnormalities suggesting the presence of multiple anomalous pathways. [ABSTRACT FROM AUTHOR]

A unique instance of an anomalous chorda tendinae visualized in the left ventricular outflow tract during M-Mode and two-dimensional echocardiography, and subsequently confirmed during surgery for concomitant severe rheumatic valvular disease, is described. The M-Mode appearance can be confused with more serious forms of heart disease manifesting extraneous echoes in the outflow tract, and an approach to these echoes is described, based on a review of the literature. [ABSTRACT FROM AUTHOR]

Six cases of digitalis intoxication presenting with cardiac arrhythmias are described. Multiple cardiac arrhythmias consisting of multifocal, or unifocal, multiform ventricular ectopic beats, bidirectional tachycardia, complete heart block, accelerated junctional rhythm with exit block, nonparoxysmal junctional tachycardia, atrial fibrillation, atrial tachycardia with block, and multifocal tachycardia were observed. The presence of such multiple arrhythmias occurring simultaneously should always suggest the high possibility of digitalis intoxication. [ABSTRACT FROM AUTHOR]

The M-mode echocardiographic findings seen in 5 patients with acute rupture of the aortic valve leaflets due to infective endocarditis are described. These findings embrace a wide spectrum of abnormalities seen in the aortic root in diastole and they are (1) fine, high frequency oscillating echoes, (2) thick oscillating bands of echoes, and (3) dense shaggy echoes loosely attached to the aortic valve leaflets. Three patients showed persistence of these aortic root echoes right up to the level of the left ventricular outflow tract. All 5 patients demonstrated early closure of the mitral valve and exaggerated motion of the interventricular septum and the posterior wall of the left ventricle. Two patients died from the illness and the remaining 3 had successful aortic valve replacement after appropriate antibiotic therapy. The aortic valve and the aortic root were carefully examined in all 5 patients either at necropsy or at operation. Two patients had leaflet perforation alone, whereas the remaining 3 had both leaflet perforations as well as vegetations. An attempt was made to correlate morphologic findings with the echocardiographic abnormalities. It is concluded that it is frequently difficult from abnormal echoes in the aortic root alone to differentiate between ruptured leaflets and vegetations. However, the presence of the combination of early closure of the mitral valve, exaggerated motion of the interventricular septum and the posterior wall of the left ventricle, together with abnormal aortic root echoes as described above should strongly suggest acute rupture of the aortic valve leaflets due to infective endocarditis, or in rare cases myxomatous degeneration of the aortic valve. [ABSTRACT FROM AUTHOR]

The electrocardiographic patterns in leads V7, V8, and V9 were studied in 225 young, normal men (age range 17 to 21 years). The prevalence of 0.5- to 1.0-mm ST-segment elevation in leads V7, V8, and Vg 0.08 second after the J point was 8.9%, 5.8%, and 3.1%, respectively; the ST-segment elevation was not >1.0 mm in any subject. [ABSTRACT FROM AUTHOR]

RACIONAL: Tratamento neoadjuvante com radioterapia e quimioterapia é o esquema preferencial para câncer de reto localmente avançado, tendo por objetivo aumentar a ressecabilidade e diminuir a recidiva local. OBJETIVO: Avaliar os benefícios da operação tardia após radioterapia e quimioterapia neoadjuvante em câncer de reto localmente avançado quanto à resposta da regressão tumoral, sobrevida e efeitos adversos. MÉTODOS: Foram tratados consecutivamente 106 pacientes, portadores de adenocarcinoma do reto localmente avançado no período pré-operatório com radioterapia na dose de 50,4 Gy (28 frações) e quimioterapia com 5-fluoracil e leucovorin. A operação foi programada entre cinco e seis semanas. Pacientes que retornaram após seis semanas por motivos diversos foram agrupados em grupo de operação tardia. Variáveis como diminuição do estádio, remissão tumoral completa, tempo cirúrgico, transfusão sanguínea, recidiva local, metástase e sobrevida foram correlacionadas com o restante dos pacientes a fim de verificar os seus benefícios. RESULTADOS: Remissão completa do tumor foi encontrada em 15 pacientes (T0=15/106 - 14,2%). Resposta parcial em 38 (34,9%); entretanto em um paciente a resposta foi pT0N2. O seguimento médio foi 35,6 semanas e 32,2 semanas para grupo de operação em seis semanas e grupo de cirurgia tardia. Não houve diferença entre os dois grupos quanto à diminuição de estádio, remissão tumoral completa, tempo cirúrgico, transfusão sanguínea e complicações cirúrgicas precoces. Embora a operação tardia não apresentasse diferença significante quanto à recidiva local (p=0,1468), ela mostrou tendência em menor risco de metástase à distância (p=0,0520). CONCLUSÃO: Operação tardia após tratamento neoadjuvante não oferece benefícios evidentes em termos de remissão completa ou diminuição do estádio tumoral. Fatores moleculares preditivos devem ser investigados no futuro para melhor seleção de doentes que poderão beneficiar-se com o tratamento neoadjuvante.BACKGROUND: Neoadjuvant treatment with radiotherapy and chemotherapy is the preferred regimen for locally advanced rectal cancer, aiming to increase resectability and decrease local recurrence. AIM: To evaluate the benefits of delayed surgery after neoadjuvant chemoradiation in advanced rectal cancer regarding aspects of tumor response, survival and its deleterious effects. METHODS: Were treated 106 patients consecutively with locally advanced rectal adenocarcinoma. Neoadjuvant chemoradiation with a dose of 50.4 Gy (28 fractions), 5-fluoracil and leucovorin was given. Surgery was scheduled within five to six weeks. Patients who returned later than six weeks for the scheduled surgery were grouped into the delayed group and variables such as the downstaging rate, complete response, surgical time, blood transfusion, local recurrence, distant metastasis and survival were correlated with the remaining patients in order to determine the benefits of the delayed surgery. RESULTS: Complete tumor response was found in 15 patients (T0=15/106 - 14.2%). Partial response was achieved in 38 patients (34.9%), while one patient had pT0N2 staging. The mean follow-up was 35.6 weeks for the six weeks group, and 32.2 weeks for the delayed group. There were no significant differences between the two groups in terms of downstaging, complete tumor response, surgical time, blood transfusion and early post-operative complications. Although delayed surgery didn't have a significant difference regarding the local recurrence (p=0.1468), it showed a strong tendency in the delayed group of having a lower risk of distant metastasis (p=0.0520). CONCLUSION: Delayed surgery after chemoradiation offered no clear benefits in terms of complete tumor response or downstaging. Predictive molecular factors should be investigated in the future for the proper selection of patients who will benefit from chemoradiation.

The diagnosis of constipation is complicated due to the multiplicity and complexity of the causes. Regarding diagnostic tests, proctography is the best choice because it provides information on functions and visualization of abnormalities. Objective: To measure the isolated value of proctography in patients with obstructed defecation. Method: We evaluated 40 constipated patients at the Coloproctology Clinic of Santa Casa de Misericórdia de São Paulo. The test was performed by introducing 120 mL of barium contrast in the rectum and by analyzing the different stages of evacuation. Three x-rays were performed in the lateral position: rest, anal contraction and evacuation. Results: The diagnoses were: rectocele: 2 (5.0%); anismus: 8 (20.0%); perineal descent: 13 (32.5%); sigmoidocele: 6 (15.0%); internal invagination: 10 (25.0%); rectocele + sigmoidocele 9 (22.5%); rectocele + internal invagination 11 (27.5%); rectocele + anismus: 18 (45.0%). Several patients presented multiple disorders. Conclusion: Constipation by obstructed defecation depends on multiple factors and it is important to have an accurate diagnosis. Proctography is essential, but insufficient as a single procedure. The other tests contribute with the diagnosis, therefore, they should be included in the investigation.O diagnóstico da constipação é difícil pela multiplicidade e complexidade das causas. Dos exames diagnósticos, a proctografia é preferida, fornecendo informações da função e visualização de anormalidades. Objetivo: Medir o valor isolado da proctografia, em pacientes com diagnóstico de defecação obstruída. Método: Avaliamos 40 pacientes com constipação intestinal do Ambulatório de Coloproctologia da Santa Casa de Misericórdia de São Paulo. O exame foi feito introduzindo-se 120 mL de contraste no reto e analisando-se as diferentes fases da evacuação. Foram realizadas três radiografias na posição lateral: repouso, contração anal e evacuação. Resultados: Os diagnósticos foram: retocele: 2 (5,0%); contração paradoxal do puborretal: 8 (20,0%); descida perineal: 13 (32,5%); sigmoidocele: 6 (15,0%); invaginação interna: 10 (25,0%); retocele + sigmoidocele: 9 (22,5%); retocele + invaginação: 11 (27,5%); retocele + contração paradoxal: 18 (45,0%). Vários pacientes apresentaram distúrbios múltiplos. Conclusão: Constipação por defecação obstruída depende de múltiplos fatores e é importante o diagnóstico preciso. A proctografia é essencial, mas insuficiente como procedimento isolado. Os outros exames são importante contribuição para firmar o diagnóstico, devendo ser incluídos na investigação.

Cites a case of congenital fistulas involving the internal mammary artery (IMA) and the innominate vein. Details on the clinical diagnosis of the patient; Frequency of the communication of the fistulas of the middle third of the IMA with a branch of the pulmonary artery; Catheterization of the right-heart showing normal pressures after the diagnosis.

In patients with valvular heart disease, fever, and cardiomegaly echocardiography is an invaluable noninvasive tool. In this report we describe a young female presenting with cardiac tamponade due to acute rheumatic carditis. Echocardiography showed an exudative pericardial effusion which was haemorrhagic on pericardiocentesis. She responded to steroid therapy with resolution of carditis and pericardial effusion. [ABSTRACT FROM PUBLISHER]

, , 657-659. A 19-year-old Chinese woman was admitted to hospital with cardiac tamponade. Pericardial fluid analysis and other investigations failed to reveal a cause of the pericardial effusion and she was treated as for tuberculous pericarditis. Subsequently haematological investigations showed that she was suffering from an acute lymphoblastic leukaemia. [ABSTRACT FROM PUBLISHER]

Abstract Background Biclustering is an important analysis procedure to understand the biological mechanisms from microarray gene expression data. Several algorithms have been proposed to identify biclusters, but very little effort was made to compare the performance of different algorithms on real datasets and combine the resultant biclusters into one unified ranking. Results In this paper we propose differential co-expression framework and a differential co-expression scoring function to objectively quantify quality or goodness of a bicluster of genes based on the observation that genes in a bicluster are co-expressed in the conditions belonged to the bicluster and not co-expressed in the other conditions. Furthermore, we propose a scoring function to stratify biclusters into three types of co-expression. We used the proposed scoring functions to understand the performance and behavior of the four well established biclustering algorithms on six real datasets from different domains by combining their output into one unified ranking. Conclusions Differential co-expression framework is useful to provide quantitative and objective assessment of the goodness of biclusters of co-expressed genes and performance of biclustering algorithms in identifying co-expression biclusters. It also helps to combine the biclusters output by different algorithms into one unified ranking i.e. meta-biclustering.

OBJETIVO: Estudar as possibilidades técnicas e resultados obtidos com pequenas incisões para tratar doenças do cólon. MÉTODO: Vinte e seis pacientes, 12 do sexo masculino e 14 do feminino foram submetidos a laparotomias com incisões menores que 10cm. As minilaparotomias variaram entre 3,6 e 10cm (média - 7,11cm), paramedianas e realizadas sobre a área tumoral localizada por palpação ou colonoscopia. Várias operações foram realizadas: hemicolectomias direitas, sigmoidectomias, colectomias segmentares e colotomias. As doenças tratadas foram: adenocarcinoma (20), lipoma (1), pólipo adenomatoso (1), carcinóide (1), Crohn íleo-cecal (1), adenoma viloso (1) e mucocele (1). RESULTADOS: Vinte e cinco enfermos evoluíram sem complicações. Uma paciente de 90 anos, com câncer de cólon ocluído e disseminado faleceu com broncopneumonia e com função intestinal normal. As funções intestinais retornaram cedo: emissão de gases no 2º e 3º dias, evacuações no 3º e 4º dias. CONCLUSÕES: Tumores menores que 8cm puderam ser facilmente operados através de minilaparotomias. Tumores maiores ou fixos não devem ser operados por pequenas incisões. Princípios oncológicos foram respeitados como na cirurgia convencional. A recuperação dos doentes foi confortável e sem queixa de dor significativa. O efeito cosmético foi excelente.

Objective: Free tissue transfer is a powerful reconstructive method for patients with substantial diabetic foot ulcers. This study aimed to perform an updated systematic review and meta-analysis investigating the flap characteristics, concurrent revascularisation rates, complications, and outcomes associated with free tissue transfer in diabetic foot ulcers., Methods: Two reviewers performed a systematic review of various databases since their inception, with no language restriction. Only data for free tissue transfer in non-traumatic diabetic foot ulcer patients were extracted from included studies where a heterogeneous population was studied. Outcome data were pooled using random effects meta-analysis for binomial data., Results: Of 632 studies identified, 67 studies encompassing 1 846 patients and 1 871 free flaps were included. A median of 18 patients [IQR 9, 37] per study, with a median age of 58.5 years [56, 63], were followed up for a median of 15 months [7, 25]. Most studies had serious risk of bias (n = 47 studies, 70%); sixteen (24%) had moderate risk of bias; and four (6%) had low risk of bias. The proportion of patients who underwent revascularisation was 75% (95% CI 60 - 87%; n = 36 studies) with a median time of 8 days between procedures. The pooled complete flap survival, major amputation, and ambulation rates were 88% (85 - 92%, n = 49 studies), 10% (7 - 14%, n = 50 studies), and 87% (80 - 92%, n = 36 studies), respectively. Death at individual study follow up was 6% (3 - 10%, n = 26 studies). The overall certainty of evidence was very low., Conclusion: Free tissue transfer may be a useful treatment modality for recalcitrant diabetic foot ulcers in selected patients. Future studies should investigate long term functional outcomes and aim to develop patient selection algorithms to select the most suitable candidates for this procedure., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)