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INTRODUCTION Early feeding was previously considered to increase the risk of postprocedural bleeding. However, many trials have demonstrated the benefits of early feeding after therapeutic endoscopic procedures. We conducted a meta-analysis of randomized controlled trials to evaluate the safety and outcomes between early feeding and delayed feeding after therapeutic endoscopic procedures. METHODS Medline (PubMed), Embase, Google Scholar, the Cochrane Library, and clinicaltrials.gov were searched to identify randomized controlled trials that met our inclusion criteria. The pooled data for the mortality rate, postprocedural bleeding rate, and length of hospital stay were analyzed. RESULTS A total of seven trials consisting of 717 patients were reviewed. These seven trials examined various therapeutic endoscopic procedures. Three trials included patients undergoing endoscopic hemostasis for upper gastrointestinal bleeding, two included patients undergoing esophageal variceal ligation, and two included patients with gastric neoplasm treated with endoscopic submucosal dissection. Although no significant differences were observed in the postprocedural bleeding rate or the mortality rate between patients who received early feeding and those who received delayed feeding, early feeding resulted in shorter hospital stays (weighted mean difference -1.04, 95% confidence interval -1.45 to 0.63). CONCLUSION Early feeding appears to be a safe management method for patients undergoing therapeutic endoscopic procedures. Therefore, we recommend early feeding for these patients.

Background: Hepatocellular carcinoma (HCC) remains an aggressive malignancy with a poor prognosis and a leading cause of cancer-related mortality globally. Cumulative evidence suggests critical roles for endoplasmic reticulum (ER) stress and unfolded protein response (UPR) in chronic liver diseases. However, the role of ER stress in HCC pathogenesis, aggressiveness and therapy response remains unclear and understudied. Objectives: Against this background, the present study evaluated the therapeutic efficacy and feasibility of notopterol (NOT), a furanocoumarin and principal component of Notopterygium incisum, in the modulation of ER stress and cancer stemness, and the subsequent effect on liver oncogenicity. Methods: An array of biomolecular methods including Western blot, drug cytotoxicity, cell motility, immunofluorescence, colony and tumorsphere formation, flow-cytometric mitochondrial function, GSH/GSSG ratio, and tumor xenograft ex vivo assays were used in the study. Results: Herein, we demonstrated that NOT significantly suppresses the viability, migration, and invasion capacity of the human HCC HepJ5 and Mahlavu cell lines by disrupting ATF4 expression, inhibiting JAK2 activation, and downregulating the GPX1 and SOD1 expression in vitro. NOT also markedly suppressed the expression of vimentin (VIM), snail, b-catenin, and N-cadherin in the HCC cells, dose-dependently. Treatment with NOT significantly attenuated cancer stem cells (CSCs)-like phenotypes, namely colony and tumorsphere formation, with the concomitant downregulation of stemness markers OCT4, SOX2, CD133, and upregulated PARP-1 cleavage, dose-dependently. We also demonstrated that NOT anticancer activity was strongly associated with increased cellular reactive oxidative stress (ROS) but, conversely, reduced mitochondrial membrane potential and function in the HepJ5 and Mahlavu cells in vitro. Our tumor xenograft studies showed that compared with sorafenib, NOT elicited greater tumor growth suppression without adverse changes in mice body weights. Compared with the untreated control and sorafenib-treated mice, NOT-treated mice exhibited markedly greater apoptosis ex vivo, and this was associated with the co-suppression of stemness and drug-resistance markers OCT4, SOX2, ALDH1, and the upregulation of endoplasmic reticulum stress and oxidative stress factors PERK and CHOP. Conclusions: In summary, we demonstrated for the first time that NOT exhibits strong anticancer activity via the suppression of cancer stemness, enhanced endoplasmic reticulum stress and increased oxidative stress thus projecting NOT as a potentially effective therapeutic agent against HCC.

Background: Refractory ventricular tachycardia (VT) can progress to acute heart failure, ventricular fibrillation, and sudden cardiac death. We introduced an alternative treatment for refractory hemodynamically stable VT storm, that is, double sequential external synchronization (DSES).Case presentation: We present a case report of a middle-aged Asian male diagnosed with refractory hemodynamically stable VT storm in which DSES successfully restored cardiac rhythm to normal sinus rhythm after several attempts of treatment with pharmacological agents and single-dose electrical cardioversion failed. The patient’s symptoms were relieved after termination of VT storm.Conclusion: This article provides a potential treatment option for hemodynamically VT that has poor response to conventional pharmacological and single electrical cardioversion.

Introduction. Unintentional injury remains the leading cause of death in children worldwide. Adequate parental supervision is a crucial strategy for preventing injury. Many factors, such as a large family size, poor socioeconomic status, and the caregiver being a single mother, contribute to unintentional injury in children. In addition, sleep deprivation in caregivers might be associated with injury in children because sleep deprivation causes impaired daytime cognitive function, wake-state instability, and negative moods, thereby impairing caregiver supervision. Therefore, this study determines the association between injury in children and the sleep quality of their primary caregivers. Method. This is a retrospective case–control study on unintentional injury in children aged 0 to 4 years who visited the emergency department (case group) and an age- and sex-matched control group. Sleep quality in caregivers was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to evaluate the association between aspects of the PSQI and injury. A propensity score model was used to generate a quasirandomized design. Results. This case-control study recruiting 277 injured and 274 noninjured children was conducted in Taiwan. There was no statistically significant difference in child’s age and primary caregiver’s age between the injured and noninjured groups. The primary outcome, Pittsburgh sleep quality index, was not significantly different between the two groups. The average scores of sleep duration and habitual sleep efficiency in the control group were higher than those in the case group. However, there was no difference between the two groups after adjusting via a propensity score model, including the following potential confounders, child’s age, child’s sex, number of previous injury, caregiver mental status, caregiver’s sex and caregiver’s age, and the number of children living together. Conclusion. Our study was the first to examine the association between injury in children and the sleep quality of their primary caregivers. We observed that no PSQI component significantly affected the risk of injury among children.

Objective Currently, infections due to foreign-body reactions caused by bacteria or implant materials at the wound site are one of the major reasons for the failure of guided tissue regeneration (GTR) and guided bone regeneration (GBR) in clinical applications. The purpose of this study was to develop regeneration membranes with localized cobalt ion release to reduce infection and inflammation by polycaprolactone (PCL)/cobalt-substituted hydroxyapatite (CoHA). Methods The PCL composite membrane containing 20 wt% CoHA powders was prepared by solvent casting. The surface morphology, crystal structure, chemical composition and thermal properties of PCL composite membranes were characterized. The biocompatibility, osteogenic differentiation and antibacterial properties of composite membrane were also investigated. Then, in biodegradability was assessed by immersing phosphate buffer solution (PBS) for 6 months. Results Physicochemical analyses revealed that CoHA is evenly mixed in the membranes and assistance reduce the crystallinity of PCL for getting more degradation amounts than PCL membrane. Osteoblast cells culture on the membrane showed that the CoHA significantly increases cell proliferation and found the calcium deposition production increased over 90% compared with PCL after 7 days of culture. A good antibacterial effect was achieved by the addition of CoHA powder. The results were confirmed by 2.4 times reduction of proliferation of Escherichia coli (E. coli) seeded on the composite membrane after 24 h. Immersing in PBS for 6 months indicated that PCL–CoHA composite membrane has improved biodegradation and can continuously remove free radicals to reduce the inflammatory response. Significance The PCL–CoHA composite membrane with suitable releasing of cobalt ion can be considered as a potential choice for bone tissue regeneration.

The objective of this study was to evaluate the efficacy of the red wine extract of onion (RO) and red wine (RW) on alleviating the risk factors of cardiovascular disease. During in vitro studies, various antioxidant activities [trolox equivalent antioxidant capacity (TEAC), DPPH, and H2 O2 scavenging ability] of RO and RW group were evaluated. Both RO and RW showed the maximum antioxidant capacity. During in vivo studies, 23 healthy hypercholesterolemic volunteers were randomly selected and assigned into two groups, who drunk 250 mL of RO (n = 11) or RW (n = 10) for 10 weeks. No significant changes were observed in anthropometric parameters (body weight, height, body mass, and BMI) in each group. Both RW and RO extracts elevated (p < 0.05) antioxidant activity and thereby prolonging the lag time of low-density lipoprotein oxidation. However, RO extract intake substantially suppressed (p < 0.05) the total cholesterol and low-density lipoprotein cholesterol levels when equivalence with RW thus, indicating its additional hypocholesterolemic effect. The inflammatory markers such as factor VII were also positively modulated by RO extract. Results indicated that RO extract consumption rendered better cardio protective effect than RW by altering cholesterol, improving antioxidation and suppressing inflammatory marker levels and thereby, attenuating the cardiovascular disease incidence.

Andrographolide is the major chemical component of an herbal plant, Andrographis paniculata, and has been reported to exhibit anti-cancer activity. We had previously demonstrated that andrographolide can suppress the migration and invasion of a highly metastatic melanoma cell, B16F10, but the molecular target and regulatory mechanism underlying this phenomenon remain unknown. A chemical proteomics approach using serine hydrolase activity probes and mass spectrometry-based identification was carried out to reveal that monoacylglycerol lipase (MAGL) of lipid metabolism is involved in the andrographolide-mediated suppression of B16F10 cell migration. MAGL has been reported to be elevated in aggressive cancers and associated with tumor metastasis. We observed that the hydrolase activity of MAGL in B16F10 cells was decreased upon andrographolide treatment but not in the poorly metastatic B16F1 cells. In addition, a known MAGL-specific inhibitor (JZL184) was used to demonstrate that suppression of MAGL enzyme activity could reduce B16F10 migration. Notably, overexpression of MAGL in B16F10 cells abrogated the andrographolide-mediated suppression of B16F10 migration, but such overexpression could not rescue the JZL184-mediated suppression. Further analysis showed a downregulation of MAGL mRNA levels in B16F10 cells upon treatment of andrographolide. With the use of an IKK inhibitor (Bay11-7082), the NF-kB signaling pathway is shown to be involved in the andrographolide-mediated suppression of MAGL expression. Taken together, we herein demonstrate that andrographolide suppresses melanoma cell migration via transcriptional downregulation of monoacylglycerol lipase, providing a new anti-cancer mechanism of andrographolide and a basis for further development of potent derivatives. Citation Format: Ya-Hsin Hsu, Ting-Yun Huang, Lee-Chiang Lo, Shu-Ling Fu, Chao-Hsiung Lin. Chemical proteomics approach reveals a monoacylglycerol lipase-dependent migration suppression of melanoma cells by andrographolide. [abstract]. In: Proceedings of the AACR Special Conference on Translation of the Cancer Genome; Feb 7-9, 2015; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(22 Suppl 1):Abstract nr A2-31.

Oral squamous cell carcinoma (OSCC) is a prevalent malignancy worldwide. MicroRNAs are short non-coding RNAs that regulate gene expression and are crucial for tumorigenesis. Previously, we have identified that miR-31 is frequently upregulated in OSCC and that this miR-31 increase, together with downstream effector modulation, enhances oral carcinogenesis. We have identified higher levels of miR-31 expression in oral potential malignant disorder (OPMD) tissues compared with normal oral mucosa. Exogenous miR-31 and human telomerase reverse transcriptase (hTERT) expression were introduced into cultured normal oral keratinocytes (NOKs), which led to the immortalization; these lines were designated M31OK1 and M31OK3. These immortalized lines maintained the capability to undergo squamous differentiation. In addition, migration by both cell lines was attenuated by hTERT and miR-31 knockdown. M31OK1 carries a p53 gene mutation at codon 273. A serum-tolerant subline, M31OK1-D, exhibits potent anchorage-independent growth that is attenuated by knockdown of both hTERT and miR-31. miR-31-targeted factors inhibiting HIF (FIH), which upregulated vascular endothelial growth factor (VEGF), was found crucial for oral tumorigenesis. The proliferation, migration and epithelial-mesenchymal transition of M31OK1-D are associated with downregulation of FIH and upregulation of VEGF, which require miR-31 expression. High miR-31 expression is correlated with higher VEGF expression and lower E-cadherin expression in OPMD tissue. It can be concluded that miR-31 collaborates with hTERT to immortalize NOKs and that this may contribute to early stage oral carcinogenesis. The targeting of downstream factors by miR-31 may further advance the neoplastic progression of immortalized NOKs, allowing them to become malignant.

MicroRNAs (miRNAs) are a class of small noncoding RNAs that have important regulatory roles in multicellular organisms. However, miRNA has never been identified experimentally in protist. Direct cloning of 438 expressed miRNA tags by microRNA serial analysis of gene expression from the parasitic protist Trichomonas vaginalis identified nine candidate miRNAs. Bioinformatics analysis of the corresponding genomic region revealed that these miRNA candidates contain a classical stem–loop–stem structure of pre-microRNAs. Analysis of the 20 nt long mature tva-miR-001 showed that it is an intergenic miRNA located at the scaffold DS113596. Tva-miR-001 was differentially expressed in the trophozoite, pseudocyst and amoeboid stages. Based on the experimental results of the present study, we provided solid evidence that protist possesses a miRNA regulating network comparable with multicellular organisms for the first time.

Introduction. Mild traumatic brain injury (mTBI) has been widely studied and the effects of injury can be long term or even lifelong. This research aims to characterize the sleep problems of patients following acute mTBI.Methods. A total of 171 patients with mTBI within one month and 145 non-mTBI controls were recruited in this study. The questionnaire, Pittsburgh Sleep Quality Index (PSQI), was used to evaluate seven aspects of sleep problems. A propensity score method was used to generate a quasirandomized design to account for the background information, including gender, age, Beck’s Anxiety Index, Beck’s Depression Index, and Epworth Sleepiness Scale. The effect was evaluated via cumulative logit regression including propensity scores as a covariate.Results. Before adjustment, about 60% mTBI patients and over three quarters of control subjects had mild sleep disturbance while one third mTBI patients had moderate sleep disturbance. After adjusting by the propensity scores, the scores of sleep quality and duration were significant between mTBI and control groups.Conclusion. Our study supports that sleep problem is common in mTBI group. After adjusting the confounders by propensity score, sleep duration and subjective sleep quality are the most frequently reported problems in mTBI patients within one month after the injury.

MicroRNAs are highly conserved small noncoding RNAs that can suppress protein translation through complementary binding to target mRNAs. We used a novel approach to identify miRNA targets in the protist Trichomonas vaginalis by comparing the levels of differentially expressed proteins and genes in the trophozoite and amoeboid stages. We observed that the T. vaginalis malate dehydrogenase (Tv_MDH) gene was upregulated 20-fold in the amoeboid stage, but the protein level was reduced by 4.5-fold. Bioinformatics analysis revealed that the Tv_MDH mRNA contains putative target sites of the miR-1 family. The expression level of endogenous tva-miR-1 in the amoeboid stage was 50-fold higher than in the trophozoite stage. Transfection of trophozoites with tva-miR-1 mimics reduced Tv_MDH protein expression by 60%. Based on these experimental data, we conclude that Tv_MDH is negatively regulated by tva-miR-1. The results of this study demonstrate that a combination of proteomic and transcriptomic approaches is a powerful tool for identifying miRNA targets.

Acute abdominal pain in children is encountered frequently, and the differential diagnosis is extensive. Acute ovarian torsion in children is rare, especially at a very young age, and a difficult diagnosis to make. Infarction caused by ovarian torsion will result if the twist is not unwound spontaneously or surgically in a timely fashion. We presented a case of acute ovarian cyst torsion in a 2-year-old girl who originally presented to the emergency department with abdominal pain and vomiting. Ultimately, she was found to have a 2-cm cyst of the right ovary with concomitant torsion. Because acute ovarian torsion in a very young child is not encountered frequently, timely diagnosis is required to prevent mortality and minimize morbidity. It is important to keep ovarian torsion in the differential of any female children with acute abdominal pain. Emergency physicians should be aware that the potential of acute ovarian torsion in a very young child has a high index of suspicion and seek early operative intervention.

This paper presents a 3D graphics engine which is specifically designed to minimize the hardware cost while providing sufficient computing capability for consumer electronics with small to medium screen sizes (up to 800times600) such as digital television. The presented 3D engine consists of a fixed full 3D graphics pipeline for both geometry and rendering operation. This engine provides a standard AHB interface that makes it easily to be integrated into an AMBA-based SoC. The development of the 3D engine has gone through a rigorous design process: starting from system modeling (using System-C), RTL implementation, hardware/software co-simulation and FPGA verification to test chip fabrication. This 3D engine provides 3.3 M vertices/s and 278 Mpixels/s in maximum performance at 139 MHz using 0.18 silicon technology with 987 K gates that is sufficient for most applications for digital television. At the same time, a complete OpenGL-ES 1.1 API, windowing system, Linux operating system, device driver and a 3D performance monitoring tool have been developed for our 3D engine. This performance monitoring tool provides run-time performance information include frame rate, triangle rate, pixel rate, involved OpenGL function list, function counts, memory utilization and etc. Moreover, a built-in real-time AHB bus tracer is also provided to monitor the bus activities of the 3D engine and other components on the system bus. The bus tracer captures on-chip bus signals at ether cycle accurate or transaction levels and applies real-time compression to both levels of signals. With the performance monitoring tool and the bus tracer, the 3D application developer can easily analyze the communication of the components and fine tune the 3D application to optimize the entire SoC system performance and to satisfy performance/cost constrains on consumer electronics. Both of the hardware and software have been carefully verified and demonstrated on FPGA using ARM versatile SoC develop board.