Search

The effects of coenzyme Q10 (CoQ10) supplementation in chronic kidney disease (CKD) patients remain controversial. A systematic review of current evidence was performed to systematically and comprehensively summarize the effects of CoQ10 on cardiovascular outcomes, oxidative stress, inflammation, lipid profiles, and glucose metabolism. MEDLINE, EMBASE, and the Cochrane Library database (Cochrane Central Register of Controlled Trials) were searched to identify eligible studies investigating the effects of CoQ10 supplementation on patients with CKD. Twelve independent studies (including seventeen publications) were included in this systematic review. For CKD patients, six studies reported variable cardiovascular outcomes, which yielded inconsistent results. Regarding oxidative stress and inflammation, pooled analysis showed that CoQ10 supplementation significantly reduced malonaldehyde (WMD: − 1.15 95% CI − 1.48 to − 0.81) and high-sensitivity C reactive protein levels (WMD: − 1.18 95% CI − 2.21 to − 0.15). Regarding glucose metabolism, we found that CoQ10 supplementation resulted in significant improvements in HbA1c (WMD: − 0.80; 95% CI: − 1.35 to − 0.24) and QUICKI (WMD: 0.02; 95% CI: 0.01 to 0.03). The pooled results indicated that CoQ10 supplementation had no effects on total cholesterol, or LDL-cholesterol, or on HDL-cholesterol, and triglycerides. Our systematic review demonstrated that CoQ10 supplementation might have promising effects on oxidative stress. This work provided some clues that CoQ10 supplementation might have the potential to improve inflammation levels, glucose metabolism, cardiac structure, and cardiac biomarkers. However, the effects of CoQ10 supplementation should be confirmed in larger high-quality studies.

BACKGROUND Endothelial dysfunction is common in patients undergoing hemodialysis (HD). However, little is known about the relationship between endothelial dysfunction and coenzyme Q10 (CoQ10) levels in HD patients. METHODS Eligible HD patients were enrolled in this study according to prespecified inclusion and exclusion criteria. Endothelial function was assessed by brachial artery flow-mediated dilation (FMD). Plasma CoQ10, serum malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) levels were measured. The potential confounders identified by univariate analyses (P

A 69-year-old woman under maintenance hemodialysis was diagnosed with advanced ovarian cancer. We treated the patient with combination chemotherapy using paclitaxel and carboplatin. She experienced grade 4 thrombopenia on day 8 of the third course. The area under the concentration versus time curve (AUC) of platinum was 3.5 mg/ml·min. The interval between chemotherapy and hemodialysis was shortened starting with the fourth course. The AUC of platinum was then found to be 1.8 mg/ml·min. After seven courses of chemotherapy, the patient's CA 125 serum level dropped from 1317 to 42.6 U/ml. Nevertheless, the patient presented with long periods of severe myelosuppression. In patients on hemodialysis receiving such chemotherapy, the AUC of each cycle should be closely monitored and the dialysis schedule should be adjusted as need to reduce the risk of bone marrow suppression.

One of the most promising solutions for 100 Gb/s line-rate passive optical networks (PONs) is intensity modulation and direct detection (IMDD) technology together with a digital signal processing- (DSP-) based equalizer for its advantages of system simplicity, cost-effectiveness, and energy-efficiency. However, due to restricted hardware resources, the effective neural network (NN) equalizer and Volterra nonlinear equalizer (VNLE) have the drawback of high implementation complexity. In this paper, we incorporate an NN with the physical principles of a VNLE to construct a white-box low-complexity Volterra-inspired neural network (VINN) equalizer. This equalizer has better performance than a VNLE at the same complexity and attains similar performance with much lower complexity than a VNLE with optimized structural hyperparameter. The effectiveness of the proposed equalizer is verified in 1310 nm band-limited IMDD PON systems. A 30.5-dB power budget is achieved with the 10-G-class transmitter.

A magnet system is used in the SPERF to create the magnetic field configuration for simulating the space plasma environment. In this paper, the parameters of the system are designed to achieve the target fields needed by the scaling laws, and the electromagnetic analysis has been performed to validate the results. A procedure to obtain the parameters is proposed based on the investigation into the physical and technological constraints. The vacuum magnetic fields for studying the 3D magnetic reconnection at the magnetopause, Earth’s magnetosphere, and 3D magnetic reconnection driven by a plasma gun are computed. In addition, the engineering complexity is reviewed in brief. This research is crucial to the construction of the SPERF, and it is valuable to designing the magnets applied in other fields.

IntroductionDuring the COVID-19 pandemic, approximately 10%–35% of COVID-19 infected patients experience post-COVID sequela. Among these sequelae, pain symptoms should not be neglected. In addition, the sequelae of COVID-19 also decrease the quality of life of these populations. However, meta-analyses that systematically evaluated post-COVID pain are sparse.Methods and analysisA comprehensive screening will be performed by searching MEDLINE and Embase without language restriction from inception to August 2021. Cohort studies, case–control studies, cross-sectional studies and case series will be included. Case report and interventional studies will be excluded. Studies with less than 20 participants will be also excluded. We aim to investigate the prevalence of pain-related symptoms in patients after the acute phase of COVID-19. The impact of COVID-19 on the quality of life and pain symptoms among these populations in the post-acute phase will also be evaluated. ROBINS-I tool will be used to assess the risk of bias of cohort studies. The risk of bias tool developed by Hoy et al will be used to assess the risk of bias of prevalence studies. Metaprop command in Stata will be used to estimate the pooled prevalence of pain symptoms. DerSimonian and Laird random-effects models will be used to calculate the pooled relative risks. All analyses will be calculated using Stata software (V.15.0; StataCorp)Ethics and disseminationEthics approval is not required. Results of our study will be submitted to a peer-review journal.PROSPERO registration numberCRD42021272800.

Isoflurane, a widely used volatile anesthetic, induces neuronal apoptosis and memory impairments in various animal models. However, the potential mechanisms and effective pharmacologic agents are still not fully understood. The p38MAPK/ATF-2 pathway has been proved to regulate neuronal cell survival and inflammation. Besides, atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, exerts neuroprotective effects. Thus, this study aimed to explore the influence of atorvastatin on isoflurane-induced neurodegeneration and underlying mechanisms. Aged C57BL/6 mice (20 months old) were exposed to isoflurane (1.5%) anesthesia for 6 h. Atorvastatin (5, 10, or 20 mg/kg body weight) was administered to the mice for 7 days. Atorvastatin attenuated the isoflurane-induced generation of ROS and apoptosis. Western blotting revealed a decrease in cleaved caspase-9 and caspase-3 expression in line with ROS levels. Furthermore, atorvastatin ameliorated the isoflurane-induced activation of p38MAPK/ATF-2 signaling. In a cellular study, we proved that isoflurane could induce oxidative stress and inflammation by activating the p38MAPK/ATF-2 pathway in BV-2 microglia cells. In addition, SB203580, a selected p38MAPK inhibitor, inhibited the isoflurane-induced inflammation, oxidative stress, and apoptosis. The results implied that p38MAPK/ATF-2 was a potential target for the treatment of postoperative cognitive dysfunction.

For the synthetic aperture radar (SAR) target recognition problem, a method combining multifeature joint classification and adaptive weighting is proposed with innovations in fusion strategies. Zernike moments, nonnegative matrix factorization (NMF), and monogenic signal are employed as the feature extraction algorithms to describe the characteristics of original SAR images with three corresponding feature vectors. Based on the joint sparse representation model, the three types of features are jointly represented. For the reconstruction error vectors from different features, an adaptive weighting algorithm is used for decision fusion. That is, the weights are adaptively obtained under the framework of linear fusion to achieve a good fusion result. Finally, the target label is determined according to the fused error vector. Experiments are conducted on the moving and stationary target acquisition and recognition (MSTAR) dataset under the standard operating condition (SOC) and four extended operating conditions (EOC), i.e., configuration variants, depression angle variances, noise interference, and partial occlusion. The results verify the effectiveness and robustness of the proposed method.

Background: Considering transaminase more than the upper limit of normal value as liver injury might overestimate the prevalence of liver involvement in COVID-19 patients. No meta-analysis has explored the impact of varied definitions of liver injury on the reported prevalence of liver injury. Moreover, few studies reported the extent of hypertransaminasemia stratified by COVID-19 disease severity. Methods: A literature search was conducted using PubMed and Embase. The pooled prevalence of liver injury and hypertransaminasemia was estimated. Results: In total, 60 studies were included. The overall prevalence of liver injury was 25%. Compared to subgroups with the non-strict definition of liver injury (33%) and subgroups without giving detailed definition (26%), the subgroup with a strict definition had a much lower prevalence of liver injury (9%). The overall prevalence of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation was 19% and 22%. The prevalence of elevated ALT and AST were significantly higher in severe COVID-19 cases compare to non-severe cases (31% vs 16% and 44% vs 11%). In critically ill and fatal cases, no difference was found in the prevalence of elevated ALT (24% vs 30%) or AST (54% vs 49%). Sensitivity analyses indicated that the adjusted prevalence of ALT elevation, AST elevation, and liver injury decreased to 14%, 7%, and 12%. Conclusion: The overall prevalence of liver injury and hypertransaminasemia in COVID-19 patients might be overestimated. Only a small fraction of COVID-19 patients have clinically significant liver injury. The prevalence of hypertransaminasemia was significantly higher in severe COVID-19 cases compare to non-severe cases. Hence, in severe COVID-19 patients, more attention should be paid to liver function tests.

IntroductionCOVID-19 has spread rapidly in China and around the world. Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. However, the results were inconsistent and the analysis of epidemiological data stratified by the severity of COVID-19 was not available in previous meta-analyses. Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury.Methods and analysisWe have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model. The I² test will be used to identify the extent of heterogeneity. Publication bias will be assessed by funnel plot and performing the Begg’s and Egger’s test if adequate studies are available. We will perform a risk of bias assessment using the Joanna Briggs Institute’s critical appraisal checklist.Ethics and disseminationSince this study will be based on the published data, it does not require ethical approval. The final results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020179462.

To study the protective effect of Xingnaojing Injection on early global brain ischemia-induced deep coma in rats. Methods: The deep coma model was induced by global brain ischemia by using four-vessel occlusion method in male SD rats. According to the body weight, the rats were randomly divided into 8 groups: a model control group, three different dose of Xingnaojing Injection (1.8, 3.6 and 5.4 mL.kg-1) groups, a Xingnaojing Injection (3.6 mL.kg-1) plus PI3K inhibitor group, a naloxone injection (0.04 mL.kg-1) group and a naloxone injection (0.04 mL.kg-1) plus Xingnaojing Injection (3.6 mL.kg-1) group (n=8 per group). In addition, eight animals served as the sham group were performed same operation with the model group excepting no blockage of the blood vessels. After the operation, three different doses of Xingnaojing Injection and/or naloxone injection were given intravenously once a day for three days. Ten μL PI3K inhibitor (LY294002, 10 mmol/L) was injected via anterior cerebral ventricle at once after global brain ischemia. The awakening time after the first drug treatment, the grasping power and the autonomous activity within 10 min after the last drug treatment were recorded. The levels of both dopamine (DA) and glutamate (Glu) in cerebrospinal fluid were detected by ELISA. The pathological changes were observed in brain tissue slices with HE staining and the protein levels of Akt/p-Akt and cAMP-response element binding protein (CREB)/p-CREB in hippocampus were detected by Western blotting. Results: Comparing with the model group, single administration of Xingnaojing Injection could significantly shorten the waking time (P0.05) and continuous administration of Xingnaojing Injection for 3 d could increase grasping power, distance, frequency and duration of autonomous activities (P0.05 or P0.01) in the deep coma rat. Also, Xingnaojing Injection could inhibit these increases in neurotransmitters DA and Glu contents (P0.05 or P0.01), and improve pathological changes of hippocampal tissue. Xingnaojing Injection significantly induced protein phosphorylation of both Akt and CREB (P0.05 or P0.01); this effect was inhibited by PI3K inhibitor (P0.05 or P0.01). Moreover, the protective effects of naloxone on awakening time, grasping power, the autonomous activity and hippocampus damage in global brain ischemia-induced deep coma could be enhanced by joint use of Xingnaojing Injection (P0.05 or P0.01). Conclusion: Xingnaojing Injection could significantly improve deep coma induced by global brain ischemia in rat, which is related to inducing PI3K/Akt-dependent protein phosphorylation of CREB, and reducing hippocampal damage. The protective effect of Xingnaojing Injection is synergistically enhanced by naloxone.目的：研究醒脑静注射液对大鼠全脑缺血性深昏迷的早期保护作用及其机制。方法：雄性SD大鼠采用四血管阻塞法建立全脑缺血性深昏迷模型后分组：模型对照组、醒脑静低、中、高剂量组(1.8，3.6，5.4 mL/kg)、醒脑静(3.6 mL/kg)+PI3K抑制剂组、纳洛酮组(0.04 mL/kg)、醒脑静(3.6 mL/kg)+纳洛酮组(0.04 mL/kg)，每组8只。另设8只动物为假手术组。给药组手术后静脉给予不同剂量的醒脑静注射液和/或纳洛酮注射液，给药体积10.0 mL/kg，连续给药3 d；醒脑静+PI3K抑制剂组为造模后立即侧脑室注射10.0 μL PI3K抑制剂LY294002(10 mmol/L)，然后再给予醒脑静注射液(3.6 mL/kg)。记录首次给药后动物苏醒时间、末次给药后抓力和10 min内自主活动；采用ELISA法检测脑脊液多巴胺(dopamine，DA)和谷氨酸(glutamate，Glu)的含量；采用HE染色观察脑组织病理改变；采用蛋白质免疫印迹法检测海马组织蛋白激酶B(Akt)蛋白及其磷酸化蛋白(p-Akt)和cAMP应答元件结合蛋白(cAMP-response element binding protein，CREB)及其磷酸化蛋白(p-CREB)的表达。结果：与模型对照组比较，醒脑静注射液单次给药能明显缩短大鼠苏醒时间(P0.05)，连续给药3 d能明显增加大鼠抓力、自主活动总路程、活动次数、活动时间(P0.05或P0.01)，降低DA和Glu的含量(P0.05或P0.01)，改善海马组织病理改变。醒脑静注射液能显著诱导Akt和CREB蛋白质的磷酸化(P0.05或P0.01)。PI3K抑制剂LY294002能明显抑制醒脑静注射液对全脑缺血性深昏迷大鼠上述改善作用(P0.05或P0.01)。醒脑静注射液能显著增加纳洛酮注射液对大鼠全脑缺血性深昏迷的上述改善作用(P0.05或P0.01)。结论：醒脑静注射液能明显改善大鼠全脑缺血性深昏迷，其机制与上调PI3K/Akt介导的CREB磷酸化，调节神经递质和保护海马组织有关。醒脑静注射液与纳洛酮对大鼠全脑缺血性深昏迷有协同增效作用。.

Background: It has been found that L-carnitine ameliorated cisplatin-induced acute kidney injury (AKI) in rats. However, the detailed role of L-carnitine in improving the renal urinary concentration function in cisplatin-induced AKI is not fully understood. Methods: In this study, 30 Sprague-Dawley rats were divided randomly into 5 groups: control, cisplatin (CIS), L-carnitine (CAR), L-carnitine plus cisplatin (CAR + CIS), and cisplatin plus L-carnitine (CIS + CAR) groups. Cisplatin (7 mg/kg) and L-carnitine (300 mg/kg) were injected intraperitoneally. Urine (24 h) and blood samples were collected to analyze renal urinary concentrating function. Immunoblotting, confocal laser microscopy, and enzyme-linked immunosorbent assays were used to assess the level and localization of the water channel aquaporin (AQP) 2, and levels of stimulatory G protein α subunit (GSα protein), arginine vasopressin (AVP) receptor 2, adenylyl cyclase and serum AVP. Results: Renal urinary concentrating function was improved by L-carnitine in rats with cisplatin-induced AKI. AQP2 expression, which decreased after cisplatin treatment, was improved by L-carnitine in different regions of the kidney. Moreover, our data indicated that L-carnitine could increase AQP2 accumulation at the apical plasma membranes of the renal-collecting ducts. Finally, intervention with L-carnitine effectively improved the expression of AQP2 upstream signaling proteins, such as GSα protein, adenylyl cyclase, and serum AVP levels in rats with cisplatin-induced AKI. Conclusion: L-carnitine resolves the cisplatin-induced urinary concentration defect, which may occur by increasing AVP/cyclic adenosine monophosphate/AQP2 levels, indicating the potential use of L-carnitine to ameliorate the renal urinary concentration effect in cancer patients treated with cisplatin.

Background Elderly patients receive propofol at regular intervals for sedation during gastrointestinal endoscopy. However, the link between cognition and intermittent propofol exposure remains unclear. Thus, we used aged rats to investigate the effect of propofol on cognition. Methods The study included two parts. In the first part, aged (18–20 months old) male Sprague-Dawley rats underwent intermittent intraperitoneal injection of propofol (200 mg/kg) or intralipid, every 9 days or once a day. In the second part, some aged rats received intraperitoneal injection of Bay 11-7082 (1 mg/kg), a specific inhibitor of NF-κB, 30 min before propofol injection. Memory tests were performed to evaluate cognition 24 h after the entire treatment. The hippocampal neuronal damage was assessed by TUNEL staining. The hippocampal levels of p-NF-κB p65, NLRP3, caspase-1 p20, and cleaved caspase-3 were detected by western blotting. The hippocampal and serum levels of IL-1β, IL-6, and TNF-α were evaluated using ELISA. Results There were no differences in the behavioral tests, hippocampal neuronal damage, and neuroinflammation between groups given intralipid and propofol treatment every 9 days. However, repeated propofol treatment once a day promoted activation of NF-κB and the NLRP3 inflammasome, inducing cognitive impairment and neuroinflammation. Interestingly, pretreatment with Bay-11-7082 not only inhibited NF-κB/NLRP3 inflammasome activation, but also attenuated neuronal damage and cognitive dysfunction in aged rats exposed to daily propofol treatment. Conclusions Intermittent propofol treatment every 9 days may be safe for aged rats. However, propofol treatment once a day could impair the cognition of aged rats, partly through the activation of the NF-κB pathway and NLRP3 inflammasome, which may be a potential targets for the treatment of cognitive impairment in elderly patients.

The resource integration of the scientific and technological innovation service platform is to accurately grasp the changing trend of users’ innovation needs through big data, tap potential innovation needs, provide effective innovation services in a timely manner, and improve the utilization efficiency of innovation resources. Through the analysis of resources and the research of reorganization, it is possible to further clarify the integration mechanism of scientific and technological innovation service resources and realize the rapid and healthy development of service resources with technological integration.

The effects of early renal replacement therapy (RRT) on mortality and renal recovery in patients with acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was performed. MEDLINE, EMBASE and the Cochrane Library database (Cochrane Central Register of Controlled Trials) were searched to identify RCTs, investigating the effects of early RRT on patients with AKI. Six studies with a total of 1257 participants were included in this meta-analysis. Compared to late RRT, early RRT did not reduce the risk of mortality (RR 0.93, 95 % CI 0.68–1.26) or affect renal recovery (RR 0.88, 95 % CI 0.48–1.62) or composite endpoint (death or dialysis dependence) (RR 0.91, 95 % CI 0.71–1.17). There was no significant difference in adverse events in the analysis, between the early RRT and late RRT arms. Early initiation of RRT for patients with AKI is not associated with decreased overall mortality or a delayed renal recovery rate. The optimal time to initiate RRT remains uncertain. Large scale and adequately powered RCTs are needed to detect the effects of early initiation of RRT in AKI patients.

To date, universally accepted preventive measures for contrast-induced acute kidney injury (CI-AKI) do not exist, and they warrant further research. The purpose of this study was to evaluate the efficacy of vitamins, including vitamin C and E, for prevention of CI-AKI. We electronically searched the MEDLINE, EMBASE, and Cochrane databases. The outcome of interest was the incidence of CI-AKI. A total of 19 studies were included in this meta-analysis. Pooled analysis showed that vitamin C plus saline [relative risk (RR) = 0.63, 95% confidence interval (CI) 0.49–0.82, p = 0.0005] and vitamin E plus saline (RR = 0.39, 95% CI 0.24–0.62, p

IntroductionCoenzyme Q10 (CoQ10) is a fat-soluble vitamin-like quinone that exerts antioxidative functions and is also an important factor in mitochondrial metabolism. Plasma concentrations of CoQ10 are depressed in patients with chronic kidney disease (CKD). CoQ10 supplement can reduce adverse cardiovascular events, improve mitochondrial function and decrease oxidative stress in patients with non-dialysis CKD and dialysis CKD. We performed this study as a systematic review to comprehensively assess the effect of CoQ10 supplement on patients with CKD.Methods and analysisThe present systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols guidelines. The MEDLINE, EMBASE and Cochrane library databases will be searched without language restrictions in December 2018. Two reviewers will independently screen the references in two stages: screening of the title/abstract and then of the full-text, to identify references meeting the inclusion criteria. A descriptive overview and tabular and/or graphical summaries will be generated, and directed content analysis will be carried out on the extracted data.Ethics and disseminationThis systematic review will evaluate the efficacy and safety of CoQ10 in patients with CKD. Ethical approval is not required for this study. The results of this systematic review will be presented in relevant conferences and published in a peer-review journal.PROSPERO registration numberCRD42019120201

We report a case of metformin-associated lactic acidosis (MALA) in a 66-year-old man with end-stage renal disease on peritoneal dialysis (PD). The patient presented with severe lactic acidosis and was treated successfully with automated peritoneal dialysis (APD). During the treatment, PD solution was prepared from hemofiltration substitute fluid. The prescription was 8 cycles of 2,000 mL over 24 hours with the prepared solution, and venoclysis with sodium bicarbonate to improve the acidosis. After 3 days of treatment, his lactic acidosis was corrected. This case demonstrated that PD using hemofiltration substitute fluid is an option for patients with MALA. .

This paper uses unique data on the shareholdings of both institutional and individual investors to directly investigate whether institutional investors have better stock selection ability than individual investors in China. Controlling for other factors, we find that institutional investors increase (decrease) their shareholdings in stocks that subsequently exhibit positive (negative) short- and long-term cumulative abnormal returns. In contrast, individual investors decrease (increase) their shareholdings in stocks that subsequently exhibit positive (negative) short- and long-term cumulative abnormal returns. These findings indicate that institutional investors have superior stock selection ability in China.