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Yang-Hua Xiao,1,2 Mei-Fang Liu,1 Hongwen Wu,1,3 De-Rong Xu,1 Rui Zhao1 1Department of Clinical Laboratory, Medical Center for Burn and Plastic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China; 2School of Public Health, Nanchang University, Nanchang, People’s Republic of China; 3Department of Medical Instruments, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of ChinaCorrespondence: De-Rong Xu; Rui Zhao, Email xudr@ncu.edu.cn; zhaoruisc@163.comPurpose: Metagenomic next-generation sequencing (mNGS) is a powerful yet unbiased method to identify pathogens in suspected infections. However, little is known about its clinical effectiveness. The present study aimed to assess the efficacy of mNGS in routine clinical practice.Patients and Methods: In this single-center retrospective cohort study, 518 patients with suspected infectious diseases were assessed for inclusion. Among them, each patient had undergone mNGS testing; 407 patients had undergone both microbial culture and mNGS testing. The result of mNGS testing was compared to microbial culture performed concurrently. The diagnostic performance of mNGS was evaluated using the comprehensive clinical diagnosis as the reference standard.Results: There was a significant difference in the positive detection rates of pathogens between mNGS and culture (331/407, 81.3% vs 79/407, 19.4%, P < 0.001). The sensitivity of mNGS was much higher than the culture method (79.5% vs 21.3%, P < 0.001), especially in sample types of sputum and bronchoalveolar lavage fluid (BALF). Notably, the sensitivity of blood mNGS was relatively lower than other sample types (67.4% vs 88.9– 93.8%). Pathogen cfDNA load based on standardized stringently mapped read number at the species level of microorganisms (SDSMRN) was significantly lower in blood than in other sample types from the same patient (P = 0.0003). Importantly, mNGS directly led to a change of treatment regimen in 142 (27.4%) cases, including antibiotic escalation (15.3%), antibiotic de-escalation (9.1%), and early definitive diagnosis to initiate appropriate treatment (3.1%).Conclusion: Our in-house mNGS platform significantly improved the sensitivity for the diagnosis of infectious diseases. mNGS has the potential to improve clinical outcomes by optimizing antimicrobial therapy.Keywords: mNGS, infections, diagnostic, outcome

Context Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, or imbalanced scapular muscle activity. Evidence has shown that feedback can improve scapular control in patients with SIS. However, it is unknown whether real-time video feedback or electromyography (EMG) biofeedback is optimal for improving scapular kinematics and muscle activity during a functional task. Objective To compare the effects of video and EMG feedback sessions on absolute muscle activity (upper trapezius [UT], lower trapezius [LT], serratus anterior), muscle balance ratios (UT/LT, UT/serratus anterior), and scapular kinematics (anterior-posterior tilt, external-internal rotation, upward rotation) in SIS participants during arm elevation and lowering. Design Randomized controlled clinical trial. Setting Research laboratory. Patients or Other Participants Overhead athletes who were diagnosed with SIS and who also exhibited scapular dyskinesis (N = 41). Main Outcome Measure(s) Three-dimensional kinematics and EMG were recorded before and after feedback training. Results Lower trapezius muscle activity increased (4.2%–18%, P < .011) and UT/LT decreased (0.56–1.17, P < .013) in the EMG biofeedback training group as compared with those in the video feedback training group. Scapular upward rotation during arm elevation was higher in the video group than in the EMG group after feedback training (2.3°, P = .024). Conclusions The EMG biofeedback improved muscle control and video feedback improved the correction of scapular upward rotation in patients with SIS. Trial Registration Number ClinicalTrials.gov: NCT03252444.

Orexin is a peptide neurotransmitter released in the globus pallidus. Morphological evidence reveals that both orexin 1 receptor (OX1R) and orexin 2 receptor (OX2R) exist in the globus pallidus. Here we showed that bilateral microinjection of both orexin-A and orexin-B into the globus pallidus alleviated motor deficits in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonian mice. Further in vivo extracellular single-unit recording revealed that the basal spontaneous firing rate of the globus pallidus neurons in MPTP parkinsonian mice was slower than that of normal mice. Application of orexin-A or orexin-B significantly increased the spontaneous firing rate of pallidal neurons. The influx of Ca2+ through the L-type Ca2+ channel is the major mechanism involved in orexin-induced excitation in the globus pallidus. Orexin-A-induced increase in firing rate of pallidal neurons in MPTP parkinsonian mice was stronger than that of normal mice. Orexin-A exerted both electrophysiological and behavioral effects mainly via OX1R, and orexin-B exerted the effects via OX2R. Endogenous orexins modulated the excitability of globus pallidus neurons mainly through OX1R. The present behavioral and electrophysiological results suggest that orexins ameliorate parkinsonian motor deficits through increasing the spontaneous firing of globus pallidus neurons.

Current healthcare is centered on the perception of people’s health. The purpose of this study was to investigate the relationship between self-perceived health (physical, psychological, social, and environmental dimensions) and two main clinical symptoms (shoulder pain and restricted shoulder motion) in patients with frozen shoulders. A total of 49 patients diagnosed with frozen shoulders were recruited and divided into high- and low-disability groups according to the severity of their frozen shoulders. Participants were measured for shoulder passive range of motion, pain intensity, and self-perceived health, using a brief version of the World Health Organization Quality of Life questionnaire. The results showed that the high-disability group had poorer self-perceived health (lower quality of life scores) than the low-disability group (p < 0.05). There was no significant correlation between the quality of life scores and the two clinical symptoms in either the high- or low-disability group. Our findings revealed that the multidimensional self-perceived health of frozen shoulder patients could not be inferred from the severity of shoulder pain and restricted shoulder motions. This study suggests that healthcare providers should pay more attention to patients’ self-perceived health needs while addressing the clinical symptoms in patients with frozen shoulders.

Cerebral ischaemia/reperfusion (I/R) injury-induced irreversible brain injury is a major cause of mortality and functional impairment in ageing people. Gastrodin (GAS), derived from the traditional Chinese herbal medicine Tianma, has been reported to inhibit the progression of stroke, but the mechanism whereby GAS modulates the progression of cerebral I/R remains unclear. The middle cerebral artery occlusion method was used as a model of I/R in vivo. Rats were pretreated with GAS by intraperitoneal injection 7 days before I/R surgery and were then treated with GAS for 7 days after I/R surgery. Additionally, an oxygen–glucose deprivation/reoxygenation model using neuronal cells was established in vitro to simulate I/R injury. 2,3,5-Triphenyltetrazolium chloride and Nissl staining were used to evaluate infarct size and neuronal damage, respectively. Lactate dehydrogenase release and cell counting kit-8 assays were used to assess neuronal cell viability. Enzyme-linked immunosorbent assay, qPCR, flow cytometry and western blotting were performed to analyse the expression levels of inflammatory factors (IL-1β, IL-18), lncRNA NEAT1, miR-22-3p, NLRP3 and cleaved caspase-1. Luciferase reporter experiments were performed to verify the association between lncRNA NEAT1 and miR-22-3p. The results indicated that GAS could significantly improve the neurological scores of rats and reduce the area of cerebral infarction. Meanwhile, GAS inhibited pyroptosis by downregulating NLRP3, inflammatory factors (IL-1β, IL-18) and cleaved caspase-1. In addition, GAS attenuated I/R-induced inflammation in neuronal cells through the modulation of the lncRNA NEAT1/miR-22-3p axis. GAS significantly attenuated cerebral I/R injury via modulation of the lncRNA NEAT1/miR-22-3p axis. Thus, GAS might serve as a new agent for the treatment of cerebral I/R injury.

To investigate the effectiveness of health promotion strategies for nonspecific low back pain in hospital workers, we compared the therapeutic effects of group-based core stability exercises and an educational booklet. Subjects participated in a 60-min core stability exercise on a weekly basis for 8 weeks (N = 24) or consulted an educational booklet for advice (N = 22). The numerical rating scale (NRS), Oswestry Disability Index (ODI), and the brief version of the World Health Organization’s Quality of Life (WHOQOL-BREF) were used as outcome measures. The ODI, as well as the total score and domains of overall, physical, and psychological health in the WHOQOL-BREF were significantly improved in the exercise group (p < 0.05). The NRS score significantly improved in the booklet group (p < 0.05). The total score, psychological domain, and environmental domain of the WHOQOL-BREF improved significantly in the exercise group compared with the booklet group (p < 0.05). Group-based core stability exercises and educational booklets are helpful to hospital workers in different ways for nonspecific low back pain. In contrast to the pain reduction by the educational booklet, more active participation in group-based core stability exercise can provide a better outcome in the overall quality of life, especially in the psychological and environmental domains of hospital workers.

Orexin is a member of neuropeptides which is involved in the central motor control. The substantia nigra pars compacta (SNc) is an important nucleus participating in motor control under both physiological and pathological conditions. Morphological studies reveal that orexinergic neurons located in lateral hypothalamus innervate the SNc. Both orexin-1 receptors (OX1 R) and orexin-2 receptors (OX2 R) are expressed in the SNc. To investigate the effects of orexins on SNc, single unit in vivo extracellular recordings and behavioral tests were performed in this study. Micro-pressure administration of orexin A and orexin B significantly increased the spontaneous firing rate of nigral DAergic neurons by 65.87 ± 7.73% and 90.49 ± 17.83%, respectively. The excitatory effects of orexin A on nigral DAergic neurons were mainly mediated by OX1 R, while OX2 R were involved in the increase in firing rate induced by orexin B. Selectively blocking OX1 R and OX2 R significantly decreased the firing rate of nigral DAergic neurons by 36.77 ± 6.26% and 32.04 ± 6.12%, respectively, which suggested that endogenous orexins modulated the spontaneous firing activity of nigral DAergic neurons. Finally, both elevated body swing test and haloperidol-induced postural behavioral test showed that unilateral microinjection of orexin A and orexin B induced significantly contralateral-biased swing and deflection behavior. Meanwhile, the specific OX1 R and OX2 R antagonists produced opposite effects. The present electrophysiological and behavioral studies suggested that orexins increased the firing activity of nigral DAergic neurons and participated in central motor control. Open Practices Open Science: This manuscript was awarded with the Open Materials Badge. For more information see: https://cos.io/our-services/open-science-badges/.

Background The protective effects of gastrodin and rhynchophylline in ischaemic injury have been reported. However, the underlying mechanism and the effect of the combination of these two drugs in ischaemic injury remain unclear. Herein, we aimed to explore the effects of the combination of gastrodin and rhynchophylline on ischaemia-induced inflammasome activation as well as the underlying mechanism. Methods Middle cerebral artery occlusion (MCAO) mice and oxygen glucose deprivation (OGD)-treated BV2 cells were used as in vivo and in vitro models of ischaemia, respectively. Cerebral injury was determined by TTC staining, H&E staining and neurological deficit scores. The effects of the combination of gastrodin and rhynchophylline on inflammasome activation were measured by the MTT assay, Western blotting and ELISA. The expression of miR-21–5p and miR-331–5p was measured by qRT-PCR. The potential binding between miR-21–5p and TXNIP and between miR-331–5p and TRAF6 was analysed with Targetscan and a luciferase assay. Results MCAO-induced tissue infarction, neurological deficits, inflammasome activation, and downregulation of miR-21–5p and miR-331–5p were all mitigated by the combination of gastrodin and rhynchophylline. In OGD-treated BV2 cells, the combination of gastrodin and rhynchophylline also alleviated inflammasome activation and restored the expression of miR-21–5p and miR-331–5p. TXNIP and TRAF6 were confirmed to be targets of miR-21–5p and miR-331–5p, respectively. Moreover, OGD-induced inflammasome activation was attenuated by the overexpression of either miR-331–5p or miR-21–5p and was further attenuated by the overexpression of both. Finally, we demonstrated that a miR-21–5p inhibitor and/or a miR-331–5p inhibitor counteracted the protective effects of gastrodin and/or rhynchophylline. Conclusions The combination of gastrodin and rhynchophylline exerts neuroprotective effects by preventing ischaemia-induced inflammasome activation via upregulating miR-21–5p and miR-331–5p.

Adipose tissue is the main energy reserve of the body. When energy is required, adipocyte triglycerides stored in lipid droplets (LDs) are broken down by lipase, and free fatty acids are released to supply the physiological need. Intracellular LDs are active metabolic organelles in mammalian cells, particularly in adipocytes. The present study was aimed to investigate the morphological changes of LDs and the alternation of LD-associated perilipin family proteins during long-term lipolysis stimulated by forskolin. Primary differentiated adipocytes derived from epididymal fat pads of Sprague-Dawley (SD) rats were incubated in the presence or absence of 1 μmol/L forskolin for 24 h. Content of glycerol released to the culture medium was determined by a colorimetric assay and served as an index of lipolysis. Morphological changes of LDs were observed by Nile red staining. The mRNA level of perilipin family genes was detected by quantitative real-time PCR. The protein level and subcellular localization were examined by immunoblotting and immunofluorescence staining, respectively. The results showed that forskolin induced sustained lipolysis in differentiated adipocytes. The morphology of LDs changed in a time-dependent manner. Large clustered LDs became gradually smaller in size and eventually disappeared; in contrast, peripheral micro-LDs increased gradually in number until the cytoplasm was filled with numerous micro-LDs. The protein level of the perilipin family proteins showed obvious alternation. Mature adipocytes physiologically expressed a very low level of Plin2 protein, whereas in adipocytes stimulated with lipolytic forskolin, the protein and mRNA levels of Plin2 were significantly increased, and the increased Plin2 was specifically bound to the surface of LDs. During chronic stimulation of forskolin, the mRNA level of Plin3 was unchanged, but the mRNA levels of Plin1, Plin4 and Plin5 were significantly decreased. These results suggest that the morphology of LDs and perilipin family proteins on the surface of LDs are significantly altered during long-term lipolysis stimulated by forskolin, representing a dynamic process of the remodeling of LDs.

Aerobic exercise (AE) has been shown to improve cognition in patients with schizophrenia. However, it remains unclear whether these exercise-induced cognitive benefits persist beyond the training period. Accordingly, the present study sought to examine the immediate and maintenance effects of AE on a wide range of cognitive functions in 75 schizophrenia patients randomized to 12 weeks of either moderate-intensity treadmill exercise or stretching and toning exercise that served as a control. Participants completed assessments of neurocognition and cardiovascular fitness at pretest, posttest, and 3-month follow-up. The results showed that the AE group outperformed the controls on processing speed and attention at the end of intervention. The two groups did not differ significantly in any cognitive outcome measured at follow-up; however, improvement over time was noted in certain cognitive domains in AE group. The average effect sizes at follow-up were 0.53 and 0.35 for AE and control groups, respectively. There were no significant between-group differences in aerobic fitness at posttest and follow-up, and that fitness level was not related to changes in cognitive performance. These findings provide preliminary evidence for a trend towards beneficial effects of physical activity on cognition over a short follow-up period in favor of AE.

Parkinson's disease (PD) is the second most common neurodegenerative disease caused by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta. PD is characterized by motor dysfunctions as well as non-motor disorders. Orexin (also known as hypocretin) is a kind of neuropeptide involved in the regulation of motor control, the sleep/wake cycle, learning and memory, gastric motility and respiratory function. Several lines of evidence suggest that the orexinergic system is involved in the manifestations of PD, especially the non-motor disorders. Recent studies have revealed the protective actions and potential therapeutic applications of orexin in both cellular and animal models of PD. Here we present a brief overview of the involvement of the orexinergic system in PD, including the pathological changes in the lateral hypothalamus, the loss of orexinergic neurons and the fluctuation of orexin levels in CSF. Furthermore, we also review the neuroprotective effects of orexin in cellular and animal models of PD.

The amygdala is a complex structure involved in the regulation of emotional behaviors including fear and anxiety. The central amygdala is the main output of the amygdala and plays an important role in emotional processing. Recent studies indicate that orexin, a kind of neuropeptides responsible for maintaining wakefulness, is also associated with emotion-related behaviors, such as depression- and anxiety-like behaviors. Central amygdala receives orexinergic fibers originating from the lateral hypothalamus and expresses OX1 receptors in rats. To test the electrophysiological and behavioral effects of orexins in the central amygdala, single unit in vivo extracellular recordings, open field and elevated plus maze tests were performed in rats. Micro-pressure administration of orexin-A (0.01 mmol/L) increased the firing rate in 18 out of the 31 central amygdala neurons, while the other 13 neurons were not excited by orexin-A. The excitatory effects of orexin-A on central amygdala neurons were mainly mediated by OX1 receptors rather than OX2 receptors. Orexin-B (0.01 mmol/L) did not change the firing activity in all recorded central amygdala neurons. Selectively blocking OX1 receptors by SB-334867 (0.01 mmol/L) significantly decreased the spontaneous firing rate in 14 out of the 33 central amygdala neurons, leaving the remaining 19 neurons were not affected. However, blocking OX2 receptors by TCS-OX2–29 (0.01 mmol/L) did not change the firing activity. Finally, both open field test and elevated plus maze test showed that bilateral microinjection of orexin-A into the central amygdala induced significantly anxiolytic-like behaviors. The specific OX1 receptor antagonist tended to produce opposite effects although there was no statistical difference. The present electrophysiological and behavioral studies suggested that orexin-A participates in anxiety-like behaviors by modulating the spontaneous firing activity of central amygdala neurons.

To observe the correlation between the referred pain regions of stable angina pectoris (SAP) and the acupoints in coronary heart disease (CHD) patients and to investigate the rule of regional sensitized point distribution in rats.A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study. The tenderness was palpated along the left and right chest, back, shoulder, upper limb, etc. by a specially-assigned researcher in each hospital. Among them, 77 patients accepted pain threshold (PT) measurement by using a hand-held esthesiometer. In animal experiments, 14 SD rats were subjected to occlusion of the left anterior descending branch of the left coronary artery for 4 h for establishing myocardial ischemia (MI) model, and other 4 normal rats were used as the sham-operation control group. Four hours after MI, all the rats accepted tail venous injection of 5% Evans blue (50 mg/kg) for examining the distribution of the blue dye exudation spots at the body surface where the mechanical PT was also detected by a von Frey.In 1 046 CHD patients, 987 (94.36%) were found to have at least one tenderness spot. The tenderness spots were found at the left chest (87.47%), right chest (13.67%), left arm (ulnar side, 41.30%), right upper limb (4.68%), left shoulder back (30.21%), right shoulder back (7.07%), etc., accompanied with rash or pigmentation, subcutaneous induration, cord-like tissue contracture, skin sag, etc. The mechanical PT level was significantly lower at the tenderness spots of the left upper limb than at non-tender points of the right upper limb in CHD patients (In the case of MI, a regular "referred sensitization" response frequently occurs in the dermatomere area innervated by the corresponding segments (T 1－T 5) in both CHD patients and MI rats, which may be closely associated with the formation of acupoints in ancient China.

Individuals with Down syndrome (DS) have been characterized by greater postural sway in quiet stance and insufficient motor ability. However, there is a lack of studies to explore the properties of dynamic postural sway, especially under conditions of task-oriented movement. The purpose of this study was to investigate the relationships between task-oriented postural control and motor ability in children and adolescents with DS. The participants were 23 children and adolescents with DS (DS group, M±SD age, 14.4±2.8 years) and 18 age- and gender-matched peers (M±SD age, 13.8±3.6 years). A force plate was used to collect postural data represented by center of pressure (COP) parameters. Postural measurements were conducted for both groups in quiet standing with eyes open and with eyes closed, and also while throwing a ball at erect standing. Assessments of motor ability were only applied to the DS group by using two dimensions of the original version of Gross Motor Function Measure and 4 subtests of the Bruininks Oseretsky Test of Motor Proficiency, second edition. The results showed that while the participants with DS showed greater displacement and higher velocity of COP sways at quiet standing, they exhibited smaller COP displacement in anterior/posterior direction during throwing the ball. Three areas of motor ability, including standing motor skills, walk/run/jump motor skills and muscle strength, were found to make a significant contribution to the displacement and velocity of postural sway during the voluntary movement. It is suggested that future research should focus on investigating the definite underlying mechanism of postural sway during movement and the influence of increasing motor ability on the reactive postural sway in this population.

Two kinds of polyfluorenes bearing two lateral pyrene terminated alkyl chains and two alkyl chains per repeating unit were synthesized by Suzuki polycondensation and used to disperse single-walled carbon nanotubes (SWCNT) in organic solvents. Stable polymer-SWCNT complex can be formed via the multivalent π-π stacking interaction of the lateral pyrene functional groups and the polyfluorene backbone with the outer surface of carbon nanotubes; meanwhile the lateral alkyl chains can impart good solubility to the complex. As expected, polyfluorenes bearing lateral pyrene functional groups and octyl chains exhibited much higher carbon nanotube solubility in common organic solvents than the corresponding polyfluorenes bearing only octyl chains. Photophysical studies indicated that the formation of polymer-SWCNT complex can effectively quench the fluorescence of polyfluorenes.

Fluorene-based polymers containing perfluorooctyl moieties were designed and synthesized. The high electronegativity and F…H-C interactions are present in the fluorinated polymers, which slightly induce blue-shift of UV-Vis absorption in film. The fluoropolymer films prepared from fluorinated solvents show lager contact angles than those prepared in non-fluorinated solvents.

The sensitivity of various features that are characteristics of machine performance may vary significantly under different working conditions. Thus it is critical to devise a systematic feature extraction (FE) approach that provides a useful and automatic guidance on using the most effective features for machine performance recognition without human intervention. This paper proposes a locality preserving projection (LPP)-based FE approach for machine performance degradation recognition. Different from principal component analysis (PCA) that aims to discover the global structure of the Euclidean space, LPP is capable to discover local structure of the data manifold. This may enable LPP to find more meaningful low-dimensional information hidden in the high-dimensional observations compared with PCA. This experimental result on a bearing test-bed shows that LPP-based FE improves the performance of recognizers for identifying performance degradation of bearings.

Two new rearranged patchoulane sesquiterpene glycosides, 3α-hydroxypatchoulol 3-O-β-d-glucopyranoside (1) and 15-hydroxypatchoulol 15-O-β-d-glucopyranoside (2) together with rubusoside, a known diterpene glycoside, were isolated from the ethanol extract of the whole plant of Pogostemon cablin (Blanco) Benth. The structures of 1 and 2 were elucidated by spectroscopic analysis.

Background While many studies point out that posterior cruciate ligament plays an important role in squatting, not many, if any, have looked into knee kinematics or kinetics for isolated posterior cruciate ligament injuries. This study explores lower-limb adaptation during squatting for asymptomatic patients with isolated chronic posterior cruciate ligament injuries. Methods Thirteen research subjects or test participants with isolated chronic posterior cruciate ligament injuries were recruited to analyze the kinematics and kinetics on both sides of their hip, knees and ankle joints during squatting. We adopted ExpertVision™ motion analysis system and two Kistler force plates to record the three-dimensional trajectories of the reflective markers used and the ground reaction forces respectively. Findings The peak vertical ground reaction force exerted on the participants, their peak support moment and the knee-joint peak extension moment exhibited at their non-involved side are significantly greater than that at their involved side. We also find that the involved side's knee joint (extension moment) exhibits a reduced percentage on the peak support moment contributed by the individual joints, while the joints of the hip and ankle signify increased percentages. Interpretation In this study, the asymptomatic participants having isolated chronic posterior cruciate ligament injuries tend to shift their weight to their non-involved side, and part of their injured knee-joint load to their ipsilateral joints of the hip and ankle. The causes seem to be a habitual gravity center shift, insufficient muscle strength at the involved side, and a reduced mechanical efficiency in their extensor mechanism.

Aim. To compare the efficacies of non-nutritive sucking and glucose solution as pain-relief interventions for neonates undergoing a venipuncture procedure. Background. Neonates may be subjected to painful procedures. The individual efficacies of non-nutritive sucking or oral glucose solution used alone on pain-relief for neonates still remain controversial. Design. A randomised, parallel-group controlled trial was designed. Methods. A total of 105 neonates were randomly assigned to one of the three groups: non-nutritive sucking, glucose solution, or control group. When a neonate underwent a venipuncture during a newborn screening test, his/her pain manifestations were videotaped and subsequently measured using the Neonatal Infant Pain Scale. Both the stability analysis and the analysis of repeated relationships were performed by generalised estimating equations. Results. The level of pain was regressed over the study variables (time and group) and covariate (gestational age). Both the non-nutritive sucking and glucose solution groups had significantly lower pain scores than the control group during the venipuncture and recovery phases. Furthermore, non-nutritive sucking seemed to be more effective than glucose solution. Conclusion. Nurses can use a pain assessment tool and the pain-relief intervention to improve the quality of neonatal care in clinical practice. This study indicates that either non-nutritive sucking or glucose solution can effectively decrease the level of pain. Relevance to clinical practice. If a painful procedure on neonates is inevitable, simple, convenient and effective pain-relief methods such as non-nutritive sucking or glucose solution can be provided alone. Based on a neonate’s condition, nurses can provide 2 ml of 25% glucose solution through a syringe for a breastfeeding infant before an invasive procedure if nipple confusion is the concern.

The reaction of 2-imidazolyl carbene-derived 2-arylthiocarbamoyl imidazolium salts with ethyl propiolate proceeded via the solvent dependent tandem [3+2] cycloaddition and subsequent ring transformation processes. While the reaction in butanone yielded 3-amino-2-vinylthiopyrroles as the major products, use of benzene as the solvent led to the predominant formation of pyrrolo[2,3-b][1,4]thiazines. This work disclosed a unique ring transformation of imidazoline-spiro-pyrrolines to pyrrolo[2,3-b][1,4]thiazines, which provides a simple route to both multifunctional pyrroles and pyrrolo[2,3-b][1,4]thiazines that are otherwise difficult to synthesize.

2-aryl thiocarbamoyl benzimidazolium and imidazolinium inner salts derived from benzimidazole and imidazoline carbenes are unique ambident C-C-S and C-C-N 1,3-dipolar systems, which undergo highly efficient and site-selective cycloaddition reactions with dimethyl acetylenedicarboxylate or dibenzoylacetylene to furnish spiro(imidazole-2,3'-thiophene) derivatives in excellent yields. When treated with ethyl propiolate, methyl acrylate or acrylonitrile, spiro(imidazole-2,3'-pyrrole) derivatives were formed in good yields. Theoretical studies revealed an asynchronous concerted mechanism for both the C-C-S and C-C-N 1,3-dipolar cycloaddition reactions. The site selectivity in the [3+2] cycloaddition reaction of ambident 1,3-dipoles was predictably regulated by both the electronic and steric effects of dipolarophiles.

Antiangiogenesis is a promising strategy of cancer treatment. Vascular endothelial growth factor receptor [fetal liver kinase/kinase-inserting domain-containing receptor (KDR)] is a tyrosine kinase receptor and has been strongly implicated in tumor angiogenesis. In this study, we report that 2',4'-dihydroxy-6'-methoxy-3',5'-dimethylchalcone (ON-III), extracted from the dried flower Cleistocalyx operculatus, used in traditional Chinese medicine, reversibly inhibited KDR tyrosine kinase phosphorylation, but epidermal growth factor receptor tyrosine kinase phosphorylation was unaffected under the same concentrations of ON-III. ON-III also inhibited mitogen-activated protein kinase (MAPK) and AKT activation of KDR signal transduction in downstream molecules without reduced total MAPK and AKT. The results in vitro showed that ON-III inhibited growth of human vascular endothelial HDMEC cells in the presence of VEGF preferentially, compared with epidermal growth factor. Systemic administration of ON-III at nontoxic doses in nude mice resulted in inhibition of subcutaneous tumor growth of human hepatocarcinoma Bel7402 and lung cancer GLC-82 xenografts. The tumor vessel density decreased, as determined by immunohistochemical staining, for CD31 after ON-III treatment. These results indicated that ON-III inhibited KDR tyrosine kinase, shut down KDR-mediated signal transduction, and inhibited tumor growth of human xenografts in vivo.

A new purine nucleoside coupled with an amino acid derivative, N2-(1-methoxycarbonylethyl)guanosine 1, along with β-carboline and russulaceramide was isolated from the fruiting bodies of Amanita exitialis, a newly described poisonous mushroom. Its structure was elucidated by spectroscopic methods. This is the first report of naturally occurring nucleosides in which an α-amino acid derivative is bonded through its α-amino nitrogen to a nucleobase aglycone by a C–N bond. The new compound was found to be toxic in brine shrimp lethality test (BST).

To explore the oxidative modification effect and its mechanism of low density lipoprotein (LDL) in hyperlipidemia (HL) rats after treating with tetrahydrobiopterin (BH4).Fifty four 8-week-old male Wistar rats were used, these 54 rats were randomly divided into control group, high fat diet group (HL group), high fat diet and injected BH4 group (HL + BH4 group), and 18 in each group. The BH4 levels of blood fats and blood serum and its metabolites, the aortic reactive oxygen species, the end product malondialdehyde (MDA) and the LDL oxidation level were all determined by killing 6 experimental rats in each group at the first 8, 16, and 24 weeks of age respectively.Treating with BH4 after 8 and 16 weeks, there was no significant difference in serum lipids among three groups (P0. 05); but ROS and MDA decreased significantly (P0.01); compared with control and HL groups, the BH4 level of HL + BH4 group increased a lot (P0.01); compared with control group, the BH4 content reduced obviously in aortic homogenate of HL group (P0.01), but the total petrin levels (TB = BH4 + BH2 + B) had no significant difference (P0.05); the serum TBARS formation increased gradually with the increase of week-ages, but compared with HL group, the serum TBARS formation of HL + BH4 group reduced significantly (P0. 01).Treating with BH4 can reduced the LDL oxidation, the mechanism may be related to the correct of NOS uncoupling, the reduce of ROS generation and the decrease of LDL lipid peroxidation.

Cellular lipid droplets are active organelles. Lipid droplet-associated proteins play an important role in lipid droplet metabolism. ADRP is the major lipid-droplet associated protein presents in almost all cells that accumulate lipids. Fatty liver, atherosclerosis, diabetes and other metabolic diseases are all accompanied with excess intracellular lipid accumulation. Evidences are emerging that ADRP participates in the progress of these sever diseases. In this perspective, we concentrate on the potential functions of ADRP in various tissues either normally or abnormally.

This study compares the effectiveness of alcohol, natural drying, and salicylic sugar powder on umbilical separation time of the neonate in our high-humidity region. From September 2007 to May 2008, a total of 143 neonates in a community hospital were divided into 3 groups according to their birth month in sequence. Each umbilical care regimen was randomly assigned to a 3-month period. Data on occurrence of omphalitis and cord separation time were collected by telephone follow-up until stump separation. The salicylic sugar powder group had the lowest rates of colonization and shortest cord separation time compared with the natural drying and alcohol groups. No omphalitis developed in any of the 3 groups. Natural drying and salicylic sugar powder are safe and effective ways to care for the umbilical cord stump in high-humidity regions. Nursing professionals should consider choosing a more effective umbilical care regimen and provide mothers with thorough instruction.

A prospective longitudinal study.Diastasis recti abdominis (DRA) is defined as an increase in the inter-recti distance (IRD), or width of the linea alba. It is a common occurrence in women postpartum. Little information exists on the short- and long-term recovery of IRD and the relationship between changes in IRD and the functional performance of the abdominal muscles.To investigate the natural recovery of IRD and abdominal muscle strength and endurance in women between 7 weeks and 6 months postpartum, and to examine the relationship between IRD and abdominal muscle function.Forty postpartum (25-37 years of age) and 20 age-matched, nulliparous females participated. IRD was measured at 4 locations (upper and lower margin of the umbilical ring, and 2.5 cm above and below the umbilical ring) with a 7.5-MHz linear ultrasound transducer. Trunk flexion and rotation strength and endurance were measured with manual muscle testing and curl-ups. Evaluation was conducted at 4 to 8 weeks and 6 to 8 months after childbirth in postpartum women, and only once for the nulliparous female controls.During follow-up, the IRD at 2.5 cm above the umbilical ring and at the upper margin of the umbilical ring decreased (P = .013 and P = .002, respectively). The strength and static endurance of the abdominal muscles improved over time (P.05). A negative correlation between IRD and abdominal muscle function at 7 weeks and 6 months postpartum was found (r = 0.34 to 0.51; P.05, except for trunk flexion strength at 6 months postpartum [P = .064]). In addition, IRD changes between 7 weeks and 6 months postpartum were correlated with improvement in trunk flexion strength (Spearman rho = 0.38, P = .040). At 6 months after childbirth, postpartum women had greater mean ? SD IRDs at all 4 locations (from cranial to caudal: 1.80 ± 0.72, 2.13 ± 0.65, 1.81 ± 0.62, and 1.16 ± 0.58 cm) than those of nulliparous females (0.85 ± 0.26, 0.99 ± 0.31, 0.65 ± 0.23, and 0.43 ± 0.17 cm) (all P.001). All abdominal strength and endurance measurements were less than those of nulliparous females (all P.001).The IRD and abdominal muscle function of postpartum women improved but had not returned to normal values at 6 months after childbirth. Future research is essential to explore the need for intervention and, if needed, the effectiveness of specific intervention to reduce the size of IRD in postpartum women.

To explore the effect of remodeling and biomechanical properties after chronic treating with tetrahydrobiopterin (BH4) in spontaneously hypertensive rats.The spontaneously hypertensive rat(SHR) were given with BH4 chronically. The opening angle in the zero-stress state , wall-to-lumen area ratios (W/L) of thoracic aorta and the relationship between pressure and diameter (P-D) of mesenteric artery were measured by computer image analysis in 4, 16, and 26 week-old respectively.Treating with BH4 chronically from 4 weeks-old in SHR, there was a significant decrease in morphometric parameters of the thoracic aorta and an increase in the zero-stress state of opening angle of elastic artery. The P-D curve of mesenteric artery moved upward.Treating with BH4 prevented the structure and function of artery from abnormal changing, including to attenuate the resistant vascular hypertrophy and recover the vascular elasticity and expansibility.

To examine the relative and absolute interrater reliability of handheld dynamometers (HHD) for assessing the lower extremity muscle strength, maximal voluntary contractions (MVCs) of 16 young adults for bilateral hip and knee muscles were tested using the break method. Three MVCs of each muscle group were required for obtaining the muscle strength. Participants' muscle strengths were tested by 2 raters. The intraclass correlation coefficients (ICCs) and the smallest real differences (SRD) were used to examine the relative and absolute reliabilities, and the Bland-Altman analyses were used to check whether systematic bias exists. The results showed that the relative reliabilities of all muscle groups were excellent (ICCs = 0.83-0.92) except for the knee extensors (ICC = 0.60). The SRD represents the smallest difference that indicates a real change for a single subject. The SRD% of all muscle groups was acceptable (ranging from 8.4 to 22.8 %), with the hip extensors being the smallest and knee extensors being the largest. The reliability of the knee extensors was unsatisfactory because of poor relative and absolute reliabilities and systematic bias. In addition to assessing the relative reliability in strength measurement, the absolute reliability provides the data of the measurement error, which is useful information in clinical practice to know whether the change in strength of a subject is real. Hand-held dynamometer is a reliable tool for quantifying most of the hip and knee strength except for the knee extensors. Modifying the measuring technique for knee extension is needed in future studies to improve the reliability.

To compare the efficacies of non-nutritive sucking and glucose solution as pain-relief interventions for neonates undergoing a venipuncture procedure.Neonates may be subjected to painful procedures. The individual efficacies of non-nutritive sucking or oral glucose solution used alone on pain-relief for neonates still remain controversial.A randomised, parallel-group controlled trial was designed.A total of 105 neonates were randomly assigned to one of the three groups: non-nutritive sucking, glucose solution, or control group. When a neonate underwent a venipuncture during a newborn screening test, his/her pain manifestations were videotaped and subsequently measured using the Neonatal Infant Pain Scale. Both the stability analysis and the analysis of repeated relationships were performed by generalised estimating equations.The level of pain was regressed over the study variables (time and group) and covariate (gestational age). Both the non-nutritive sucking and glucose solution groups had significantly lower pain scores than the control group during the venipuncture and recovery phases. Furthermore, non-nutritive sucking seemed to be more effective than glucose solution.Nurses can use a pain assessment tool and the pain-relief intervention to improve the quality of neonatal care in clinical practice. This study indicates that either non-nutritive sucking or glucose solution can effectively decrease the level of pain.If a painful procedure on neonates is inevitable, simple, convenient and effective pain-relief methods such as non-nutritive sucking or glucose solution can be provided alone. Based on a neonate's condition, nurses can provide 2 ml of 25% glucose solution through a syringe for a breastfeeding infant before an invasive procedure if nipple confusion is the concern.

Umbilical cord care is a common practice after birth. Although most hospitals routinely use alcohol in the administration of cord care to newborns in Taiwan, the literature suggests that other different cord-care regimens may also be as or more effective. The purpose of this paper is to compare the effect of different cord-care regimens on cord separation time, colonization, omphalitis occurrence, and maternal satisfaction. Findings are hoped to provide nurses information essential to consider and select an optimal approach to umbilical cord care.

To investigate the effect and basis of tumor necrosis factor-alpha (TNF-alpha) on the lipid droplet associating protein adipose differentiation-related protein(ADRP) in rat differentiated adipocytes.Differentiated rat adipocytes derived from epididymal fat pads of Sprague-Dawley rats were incubated in the presence or absence of TNF-alpha (25 microg/L). Glycerol level released in the culture medium was determined by a colorimetric assay and served as an index of lipolysis. The protein levels of two lipid droplet associating proteins, perilipin and adipose differentiation-related protein, were examined by immunoblotting analysis. The intracellular lipid droplets were stained by nile red and the localizations of perilipin and ADRP on the lipid droplets were determined by immunostaining.On day 5 or day 8 after the differentiation of adipocytes, TNF-alpha significantly stimulated lipolysis. The lipolysis response to TNF-alpha occurred apparently at hour 8 and remained high 48 h after the stimulation. TNF-alpha increased the protein levels of ADRP, downregulated perilipin proteins but promoted its phosphorylation level. TNF-alpha caused the lipid droplet dispersion, whereas ADRP and perilipin proteins were remained to associate with the surface of the dispersed lipid droplets.Chronic stimulation of lipolysis by TNF-alpha resulted in the dispersion of the lipid droplets and therefore upregulated the levels of ADRP proteins.

The reaction of 2-imidazolyl carbene-derived 2-arylthiocarbamoyl imidazolium salts with ethyl propiolate proceeded via the solvent dependent tandem [3+2] cycloaddition and subsequent ring transformation processes. While the reaction in butanone yielded 3-amino-2-vinylthiopyrroles as the major products, use of benzene as the solvent led to the predominant formation of pyrrolo[2,3-b][1,4]thiazines. This work disclosed a unique ring transformation of imidazoline-spiro-pyrrolines to pyrrolo[2,3-b][1,4]thiazines, which provides a simple route to both multifunctional pyrroles and pyrrolo[2,3-b][1,4]thiazines that are otherwise difficult to synthesize.

Caring for infants with neonatal opiate abstinence syndrome is a challenge for nursing staff. These infants are at high risk for many complications. Nurses should be aware of the influences on neonates of maternal opium addiction during pregnancy. This article discusses clinical manifestations of neonatal opiate abstinence syndrome, common assessment tools for neonatal abstinence syndrome, and a variety of medical treatments and nursing interventions. In order to obtain adequate medical care for the neonates and safely alleviate their neonatal abstinence system, nurses should develop a comprehensive discharge plan and seek community support for the neonate's family.

To review systematically studies examining the association between sedentary lifestyle and low back pain (LBP) using a comprehensive definition of sedentary behaviour including prolonged sitting both at work and during leisure time. Journal articles published between 1998 and 2006 were obtained by searching computerized bibliographical databases. Quality assessment of studies employing a cohort or case–control design was performed to assess the strength of the evidence. Using pre-determined keywords, we identified 1,778 titles of which 1,391 were considered irrelevant. Then, 20 of the remaining 387 publications were scrutinized for full review after an examination of all the 387 abstracts. Finally, 15 studies (10 prospective cohorts and 5 case–controls) were included in the methodological quality assessment, of which 8 (6 cohorts and 2 case–controls; 53%) were classified as high-quality studies. One high-quality cohort study reported a positive association, between LBP and sitting at work only; all other studies reported no significant associations. Hence, there was limited evidence to demonstrate that sedentary behaviour is a risk factor for developing LBP. The present review confirms that sedentary lifestyle by itself is not associated with LBP.

Preterm and term neonates often suffer pain from procedures during their hospitalization. Due to the lack of verbal abilities of preterm and term neonates to express the pain experience, physiological and behavioral manifestations can reflect their pain levels. Clinical nursing staff usually assesses neonates' pain based on nurses' own experience and rarely use standard procedures of pain management. The purpose of this paper is to summarize current pain assessment tools developed for neonates and various pharmaceutical and non-pharmaceutical pain interventions. Nursing staff should have sufficient knowledge and a positive attitude towards neonates' pain management in order to reduce short-term and long-term negative influences on neonates.

Triglycerides are stored in intracellular lipid droplets in mammalian cells. Current evidences suggest that the intracellular lipid droplets are active participants in a variety of metabolic processes, and thus are considered as functional organelles in cells. The lipid droplet is composed of a triglyceride core surrounded by a phospholipid monolayer in which several proteins are embedded. Four of these proteins belong to a family of structurally related PAT protein, which includes perilipin, ADRP, TIP47 and S3-12. In this review, we summarize the functions of these proteins in the modulation of lipolysis and lipid droplets formation.

N-Heterocyclic carbene derived 2-phenylthiocarbamoyl benzimidazolium and imidazolinium inner salts are a unique ambident C–C–S and C–C–N 1,3-dipolar system able to undergo highly efficient and regioselective cycloaddition with dimethyl acetylenedicarboxylate and ethyl propiolate to furnish, respectively, spiro[imidazole-2,3′-thiophene] and spiro[imidazole-2,3′-pyrrole] derivatives in good to excellent yields.

This paper proposes an alternative adjustment of weights for Kohonen learning that provides a better match of topology and an improved representation of the input data. Based on the adjustment of weights, a new weighted energy function is defined. Then we propose a new scheme that applies the multiple training concept to the weighted energy function. The new scheme results in a better directional adjustment of weights and increases the training speed of the network dramatically. Finally experimental results demonstrate that much better recognition rate is obtained.