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BackgroundInfection is a devasting complication after arthroplasty. Identifying potential sources contributing to intraoperative bacterial transmission can help to reduce surgical-site infections.ObjectiveThe aim of this study was to identify the incidence and risk factors of intraoperative bacterial contamination (IBC) in primary total knee arthroplasty (TKA) procedures.MethodsActive surveillance cultures were used to detect IBC from 125 consecutive unilateral primary TKAs. The cultures were taken from different sites (surgical instruments, gloves of surgeons and surgical incisions) at different time points (before surgery, 30 min and at the end of the surgery) during arthroplasty procedures. Patient characteristics, including age, height, body weight, body mass index, comorbidity of diabetes mellitus, operative duration, intraoperative blood loss, types of prophylactic antibiotics were recorded. The white blood cell level before, the 3rd and 7th day after surgery were measured and recorded. In addition, patients were also followed for fever and surgical-site infections within 14 days after surgery.ResultsIn total, 1,000 cultures were taken. 91 (9.1%) of them showed an IBC. None of bacterial cultures of gloves and instruments before surgery were positive. At 30 min from the beginning of the procedure, 29 cultures (7.7%) from 16 patients (12.8%) showed a contamination. At the end of the surgery, 62 cultures (16.5%) from 32 patients (25.6%) showed a contamination. There were 15 cases (12.0%) of fever within 14 days after surgery, of which 11 cases with IBC, and 4 cases without IBC. No postoperative surgical-site infection occurred in all consecutive unilateral primary TKAs. The binomial logistic regression analyses confirmed that operative duration was the risk factor of IBC [OR 1.137 (95% CI 1.023 to 1.322), p = 0.014]. Moreover, compared to control group, the patients with IBC had a greater change of white blood cell level in the 3rd day after surgery (p = 0.022), and a higher risk of fever within 14 days after surgery (p

Abstract Intrahepatic cholestasis of pregnancy (ICP) can lead to many adverse pregnancy outcomes, and the influencing factors remain unclear at present. This study retrospectively analyzed clinical data from 1815 pregnant women with ICP and evaluated the relationship between ICP subtypes, gestational age at onset, and pregnancy outcomes. The results of this study show that during pregnancy, the levels of biochemical indicators (TBA, DBIL and ALT) in the serum of pregnant women initially diagnosed with subtypes of ICP were noted to constantly change, and the subtype of ICP and its severity also changed. The incidence of adverse pregnancy outcomes [meconium-stained amniotic fluid (MSAF), NICU transfer, Apgar score ≤ 7 at 1 min, and preterm birth] in patients with ICP1 (icteric type) was significantly higher than for patients with ICP2, ICP3 or ICP4. The preterm birth rate of early-onset ICP was higher than that of late-onset ICP in ICP1 and ICP3 subtypes. In conclusion, the outcome of pregnancy in women with ICP is closely related to the serum TBA level and ICP subtype, which should be recognized in the clinic.

Abstract Background A post-marketing surveillance of blonanserin has been ongoing since September 2018. The aim of this study was to assess the effectiveness and safety of oral blonanserin in Chinese young and middle-aged female patients with schizophrenia in real clinical settings, using the data from the post-marketing surveillance. Methods A 12-week, prospective, multi-center, open-label, post-marketing surveillance was conducted. Female patients aged 18–40 years were included in this analysis. The Brief Psychiatric Rating Scale (BPRS) was used to evaluate the effectiveness of blonanserin in improving psychiatric symptoms. The incidence of adverse drug reactions (ADRs) such as of extrapyramidal symptoms (EPS), prolactin elevation and the weight gain were used to evaluate the safety profile of blonanserin. Results A total of 392 patients were included both in the safety and full analysis sets, 311 patients completed the surveillance protocol. The BPRS total score was 48.8 ± 14.11 at the baseline, decreasing to 25.5 ± 7.56 at 12 weeks (P

Cracks affect the strength of rock masses and eventually threaten their stability in engineering. In order to study the fracture characteristics and mechanical properties of cracked rocks, uniaxial compression tests of pre-cracked granite samples with a central circular through hole were carried out by using MTS816 rock mechanics testing system. The inclination angles of different pre-cracks are 0°, 15°, 30°, 45°, 60°, 75°, and 90° respectively, and the influence of the crack stop hole near the crack tip on the failure behavior of pre-cracked samples is also considered. The results indicate that, compared with the intact sample, the peak strength of pre-cracked samples decreases significantly and is related to the pre-crack inclination angle. The failure mode of the sample varies with the pre-crack inclination angle, and the crack stop hole near the crack tip also has a certain influence on the crack growth to a certain extent. However, in terms of failure mode and its transformation law, the influence of central circular through hole and crack stop hole can be ignored. Generally speaking, the larger the inclination angle of the pre-crack, the more the total energy required for failure of the sample, and the more the stored elastic strain energy. Before the peak strength, the elastic strain energy of the sample is greater than the dissipated energy, after the peak strength, the dissipated energy gradually exceeds the elastic strain energy due to energy conversion. It is found that the pre-crack reduces the energy storage capacity of the sample, and the total energy is ultimately dominated by sample integrity. The dissipated energy rate increases first, then decreases, and finally increases again, the inflection points are the end of micro-crack closure and the peak strength, respectively. The crack stop hole changes the law of energy evolution to a certain extent, which can improve the ability of rocks to accumulate energy when designed at an appropriate position, so as to improve its load-bearing capacity in a certain range. The results display the mechanical properties of pre-cracked granite samples under uniaxial compression and are conducive to its application in engineering.

Schizophrenia is an unexplained, complex and serious mental illness. Blonanserin (BNS) is a new antipsychotic drug widely used in the treatment of schizophrenia. However, large-scale clinical studies have not been conducted in China. A multi-center, prospective, open-label, 12-week surveillance was carried out to evaluate the safety and effectiveness of BNS in patients with schizophrenia in China. Safety assessments included adverse drug reactions (ADRs), extrapyramidal symptoms (EPS), akathisia, concomitant medications for EPS by the end of treatment, and the changes in body weight from baseline by the end of treatment. The effectiveness was evaluated by the Brief Psychiatric Rating Scale (BPRS). From September 2018 to May 2020, of the 1,060 patients enrolled, 1,018 were included in the full analysis set (FAS) and safety set (SS), respectively. ADRs were developed in 205 patients among the included, the incidence being 20.1%. ADRs of EPS occurred in 169 patients, the incidence being 16.6%, ADRs of akathisia occurred in 90 patients, the incidence being 8.8%; concomitant therapeutic and prophylactic agents for EPS accounts for 19.2%; 4.0% of patients had a ≥7% increase in body weight from baseline at 12 weeks after initiating treatment. Using the last-observation-carried-forward (LOCF) method, the changes in total BPRS scores were −11.2 ± 10.17 (N = 1,018), −16.8 ± 12.69 (N = 1,018) and −20.6 ± 13.99 (N = 1,018) after 2/4, 6/8, or 12 weeks, respectively. 53.5% (545/1,018) patients showed response to blonanserin treatment in week 12. The post-marketing surveillance results of BNS demonstrates safety profile and effectiveness of the drug.

ObjectiveTo analyze the effect of statins on cytokines levels in gingival crevicular fluid (GCF) and saliva and on clinical periodontal parameters of middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).MethodsSystemically healthy controls (C group, n = 62), T2DM patients not taking statins (D group, n = 57) and T2DM patients taking statins (S group, n = 24) were recruited. In each group, subjects (40-85 years) were subclassified into the h (periodontal health)group, the g (gingivitis)group or the p (periodontitis) group according to different periodontal conditions. 17 cytokines in gingival crevicular fluid (GCF) and saliva samples of each subject were measured utilizing the Luminex technology kit. Further, HbA1c (glycated hemoglobin), FPG (fasting plasma glucose), PD (probing depth), CAL (clinical attachment level), BOP (bleeding on probing), GI (gingival index) and PI (periodontal index) were recorded. Data distribution was tested through the Shapiro-Wilk test, upon which the Kruskal-Wallis test was applied followed by Mann-Whitney U test and Bonferroni's correction.ResultsLevels of IFN-γ, IL-5, IL-10 and IL-13 in the saliva of the Dh group were significantly lower than those in the Ch group, while factor IL-4 was higher (pConclusionStatins are associated with reduced PD and cytokines levels in the GCF and saliva of T2DM patients with periodontitis.

Aims: To analyze the correlation between neck circumference (NC) and non-alcoholic fatty liver disease (NAFLD) and compare the predictive value of NC for NAFLD with that of other simple anthropometric measures and other biochemical profiles. Methods: 2761 subjects, undergoing a medical check-up at the Changhai Hospital between October 01, 2012 and November 30, 2012, were recruited to the study. NC, other simple anthropometric measures, and biochemical profiles were analyzed. Results: NC in NAFLD subjects with or without elevated ALT were 38.94 ± 2.62 cm and 37.21 ± 3.06 cm respectively, which was significantly higher than that in subjects with other metabolic disorders (NC: 35.33 ± 3.03 cm) and in normal controls (NC: 32.60 ± 2.37) (both P

BACKGROUND: Genetic polymorphisms of pri-miR-34b/c and pre-miR-196a2 have been reported to be associated with the susceptibility to cancers. However, the effect of these polymorphisms and their interactions with hepatitis B virus (HBV) mutations on the development of hepatocellular carcinoma (HCC) remains largely unknown. We hypothesized that these polymorphisms might interact with the HBV mutations and play a role in hepatocarcinogenesis. METHODS: Pri-miR-34b/c rs4938723 (T>C) and pre-miR-196a2 rs11614913 (T>C) were genotyped in 3,325 subjects including 1,021 HBV-HCC patients using quantitative PCR. HBV mutations were determined by direct sequencing. Contributions of the polymorphisms and their multiplicative interactions with gender or HCC-related HBV mutations to HCC risk were assessed using multivariate regression analyses. RESULTS: rs4938723 CC genotype was significantly associated with HCC risk compared to HBV natural clearance subjects, adjusted for age and gender (adjusted odds ratio [AOR] = 2.01, 95% confidence interval [CI] = 1.16-3.49). rs4938723 variant genotypes in dominant model significantly increased HCC risk in women, compared to female healthy controls (AOR = 1.85, 95% CI = 1.20-2.84) or female HCC-free subjects (AOR = 1.62, 95% CI = 1.14-2.31). rs4938723 CC genotype and rs11614913 TC genotype were significantly associated with increased frequencies of the HCC-related HBV mutations T1674C/G and G1896A, respectively. rs11614913 was not significantly associated with HCC risk, but its CC genotype significantly enhanced the effect of rs4938723 in women. In multivariate regression analyses, rs4938723 in dominant model increased HCC risk (AOR = 1.62, 95% CI = 1.05-2.49), whereas its multiplicative interaction with C1730G, a HBV mutation inversely associated with HCC risk, reduced HCC risk (AOR = 0.34, 95% CI = 0.15-0.81); rs11614913 strengthened the G1896A effect but attenuated the A3120G/T effect on HCC risk. CONCLUSIONS: rs4938723 might be a genetic risk factor of HCC but its effect on HCC is significantly affected by the HBV mutations. rs11614913 might not be a HCC susceptible factor but it might affect the effects of the HBV mutations or rs4938723 on HCC risk.

Abstract Background Excessive inflammatory response is the primary cause of early death in patients with endotoxemia. Interleukin 22 (IL-22) has been shown to play critical roles in the modulation of infectious diseases, but its function in regulating immune responses during endotoxemia remains unclear. Methods Lipopolysaccharide (LPS) was used to induce endotoxemia mouse model with or without a recombinant fusion protein containing human IL-22 (F-652). IL-6, TNF-α, IL-1β, and MCP-1 were measured by ELISA assays. The type of macrophage was assessed by flow cytometry. Real-time PCR was used to detect the expression of S100A9. Results We found that F-652 injection significantly improved the survival rates and reduced pro-inflammatory cytokines (IL-6, TNF-a, IL-1β, MCP-1) in LPS-induced endotoxemia mice. However, the mice injected with F-652 had a higher number of infiltrated immune cells after LPS treatment, suggesting an impaired immune response. Flow cytometry analysis showed a higher number of F4/80+Ly6GhiLy6Chi cells that highly expressed M2-like macrophage markers (Ym1, Arg, CCL17) in the peritoneal cavity of the F-652-treated endotoxemia mice. Further investigation found that these suppressive M2 macrophages might be induced by F-652 since the F-652 treatment could increase S100A9 in vitro. Conclusions Our study suggests that IL-22 has a protective role against endotoxemia by inducing the development of immunosuppressive cells through S100A9.

Miniature inverted-repeat transposable elements (MITEs) are common components of eukaryotic genomes. Here the authors show that a stowaway-like MITE in the 3′-untranslated region of the riceGhd2gene can suppress translation in a DCL3a-dependent manner representing a novel role for transposons in translation.

Background/Aims: Periapical periodontitis is a common oral disease caused by bacterial invasion of the tooth pulp, which usually leads to local release of pro-inflammatory cytokines and osteolytic lesion. This study is intended to examine the effect of TNF-α on BMP9-induced osteogenic differentiation of the stem cells of dental apical papilla (SCAPs). Methods: Rat model of periapical periodontitis was established. TNF-α expression was assessed. Osteogenic markers and ectopic bone formation in iSCAPs were analyzed upon BMP9 and TNF-α treatment. Results: Periapical periodontitis was successfully established in rat immature permanent teeth with periapical lesions, in which TNF-α was shown to release during the inflammatory phase. BMP9-induced alkaline phosphatase activity, the expression of osteocalcin and osteopontin, and matrix mineralization in iSCAPs were inhibited by TNF-α in a dose-dependent fashion, although increased AdBMP9 partially overcame TNF-α inhibition. Furthermore, high concentration of TNF-α effectively inhibited BMP9-induced ectopic bone formation in vivo. Conclusion: TNF-α plays an important role in periapical bone defect during the inflammatory phase and inhibits BMP9-induced osteoblastic differentiation of iSCAPs, which can be partially reversed by high levels of BMP9. Therefore, BMP9 may be further explored as a potent osteogenic factor to improve osteo/odontogenic differentiation in tooth regeneration in chronic inflammation conditions.