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Integrated lipidomics, transcriptomics and network pharmacology analysis to reveal the mechanisms of Danggui Buxue Decoction in the treatment of diabetic nephropathy in type 2 diabetes mellitus

J Ethnopharmacol. 2021 Oct 2:114699. doi: 10.1016/j.jep.2021.114699. Online ahead of print.

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Danggui Buxue Decoction (DBT) is classical prescriptions, which contains two Traditional Chinese Medicines of Angelicae sinensis radix and Astragali radix. According to the preliminary work of our laboratory and numerous studies, it has been found that DBT has a therapeutic effect on diabetic nephropathy (DN). However, the mechanisms underlying its action remain unclear.

AIM OF THE STUDY: The aim of this study was to evaluate the impact of DBT on kidney disease in diabetic mice and further explore its protective mechanism.

METHODS: DN mice model was induced by high-fat fodder and streptozotocin (STZ). Qualitative and quantitative analysis of 6 compounds in DBT was carried out by HPLC, including calycosin-7-glucoside, ferulic acid, ononin, calycosin, formononetin, and levostilide A. Hematoxylin-Eosin (HE) staining was used to determine the degree of kidney pathological damage. The UPLC-Q Exactive MS technique was used to analyze the lipids metabolism profile of kidneys samples and multiple statistical analysis methods were used to screen and identify biomarkers. Transcriptomics analyses were carried out using RNAseq. The possible molecular mechanism was unraveled by network pharmacology.

RESULTS: Thirty-one significantly altered lipid metabolites were identified in the model group comparing with the control group. DBT improved aberrant expression of several pathways related to lipidomics, including glycerophospholipid metabolism and sphingolipid metabolism. Comprehensive analysis indicated that DBT intervention reduced the content of Cers, phosphatidylethanolamines and phosphatidylcholines in mouse kidneys by downregulating the transcription level of Degs2 and Cers, reducing lipid accumulation and promoting Akt phosphorylation by upregulating the expression of Acers and Pdk1. Network pharmacology analysis showed that components in DBT, such as kaempferol, ferulic acid and astragaloside IV, could be responsible for the pharmacological activity of DN by regulating the AGE-RAGE, PI3K/Akt, MAPK and NF-κB signaling pathways in diabetic complications.

CONCLUSIONS: These results showed that DBT may improve DN by affecting insulin resistance, chronic inflammation and lipid accumulation.

PMID:34610419 | DOI:10.1016/j.jep.2021.114699

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Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis

J Vasc Interv Radiol. 2021 Oct 2:S1051-0443(21)01389-0. doi: 10.1016/j.jvir.2021.09.019. Online ahead of print.

ABSTRACT

PURPOSE: To assess the safety and efficacy of Genicular Artery Embolization (GAE) compared with a sham procedure in the treatment of knee pain secondary to mild-moderate grade Osteoarthritis (OA).

MATERIALS AND METHODS: A multicenter, single-blinded, randomized controlled trial was conducted to evaluate knee OA symptom reduction after GAE vs sham procedure. Subjects (n=21) with mild to moderate OA and intractable knee pain were randomized 2:1 to either GAE or a sham procedure. Subjects who were randomized to the sham procedure and did not report minimal clinical improvement in both total WOMAC and VAS scores were unblinded and able to crossover to treatment at 1 month. Longitudinal data were collected for 12 months, and subjects were excluded if they required additional analgesics at follow-up. Comparisons of reductions in VAS and Total WOMAC scores were performed using mixed effects linear regression models.

RESULTS: All subjects in the sham group failed to show significant improvements at 1 month and crossed over to the treatment arm.There was a statistically significant greater pain reduction in treatment group vs sham at 1 month (50.1mm VAS; SE=10.6, 95% CI: [29.0, 72.3], p<0.01). Disability improvement was also significantly greater in the treatment group (24.7 points WOMAC; SE=10.4, 95% CI: [3.5, 45.9], p=0.02). Only minor adverse events were reported.5 subjects were excluded after increased analgesic use. Sensitivity analysis with all excluded patients confirmed significant improvements at 1 and 12 months.

CONCLUSION: In patients with mild to moderate knee OA, GAE results in symptomatic improvement greater than sham procedure with clinically significant reduction in pain and disability.

PMID:34610422 | DOI:10.1016/j.jvir.2021.09.019

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Guidelines on Design, Measurement and Statistics for Appetite

Appetite. 2021 Oct 2:105731. doi: 10.1016/j.appet.2021.105731. Online ahead of print.

NO ABSTRACT

PMID:34610394 | DOI:10.1016/j.appet.2021.105731

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A Back Table Ultraviolet Light Decreases Environmental Contamination During Operative Cases

Am J Infect Control. 2021 Oct 2:S0196-6553(21)00640-4. doi: 10.1016/j.ajic.2021.09.020. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study is to assess the impact of a germicidal ultraviolet light-emitting diode (LED) on the contamination level of a back table in the operating room (OR) during total joint arthroplasty (TJA) procedures.

METHODS: Eight Tryptic Soy Agar (TSA) petri plates were placed on a table located near the operative field and exposed to air. One plate was removed on the hour over an 8-hour time span. The back table had either an UV-LED for disinfection or a sham UV-LED. This process was repeated in 12 different ORs (6 with UV light, 6 with sham device). The plates were then incubated for 48 hours at 36° +/- 1° C. Colony forming units (CFU) were recorded 24 and 48 hours after incubation.

RESULTS: There was a statistically significant difference in total CFUs between the intervention vs. sham at 24-hours (27 vs. 95, p=0.0001) and 48-hours (38 vs. 122, p<0.0001). The multivariate analysis revealed that the 24-hour and 48-hour count, the predictors UV light (p=0.002) and hour of plate removal (p=0.050) were statistically significantly associated with CFU counts. Together, the predictor variables explained 15.8% and 23.0% of the variance in CFU counts at 24- and 48-hours, respectively.

CONCLUSIONS: A back table UV-LED may decrease environmental contamination near the operative field. This has potential to lead to a decrease in joint infection.

PMID:34610393 | DOI:10.1016/j.ajic.2021.09.020

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EXPRESS: Not just form, not just meaning: Words with consistent form-meaning mappings are learned earlier

Q J Exp Psychol (Hove). 2021 Oct 5:17470218211053472. doi: 10.1177/17470218211053472. Online ahead of print.

ABSTRACT

By leveraging Phonology-to-Semantics Consistency (PSC, Amenta, Marelli & Sulpizio, 2017), which quantifies form-meaning systematicity as the semantic similarity between a target word and its phonological nearest neighbors, wedocument a unique effect of systematicity on Age of Acquisition (AoA). This effect is also found after controlling for theeffect of neighbourhood density measured for word forms and lexical semantics and several other standard predictorsof AoA. Moreover, we show that the effect of systematicity is not reducible to iconicity. Finally, we extensively probethe reliability of this finding by testing different statistical models, analyzing systematicity in phonology and orthographyand implementing random baselines, reporting a robust, unique negative effect of systematicity on AoA, such thatmore systematic words tend to be learned earlier. We discuss the findings in the light of studies on non-arbitrary form-meaning mappings and their role in language learning, focusing on the analogical process at the interface of form andmeaning upon which PSC is based and how it could help children infer the semantics of novel words when context isscarce or uninformative, ultimately speeding up word learning.

PMID:34609218 | DOI:10.1177/17470218211053472

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A novel method for determining the X-ray beam angulation of the supraspinatus outlet view

Acta Radiol. 2021 Oct 5:2841851211043835. doi: 10.1177/02841851211043835. Online ahead of print.

ABSTRACT

BACKGROUND: Rapid and accurate quantification of the supraspinatus outlet view (SOV) is a clinical challenge.

PURPOSE: To quantify the X-ray beam angle of the SOV using the horizontal angle of the subscapular spine line (SSSL) and to further verify the feasibility of this method.

MATERIAL AND METHODS: A total of 119 patients who underwent shoulder computed tomography (CT) examination were enrolled in the retrospective study. Three-dimensional (3D) CT reconstruction was performed and manually adjusted to provide the position similar to SOV. The rotation angle of the 3D image along the long axis of the human body (marked as β) was obtained. The horizontal angle of SSSL (marked as α) was measured on the anteroposterior localizer image of shoulder CT. Pearson correlation and linear regression correlation analysis were performed. In addition, the first-time success rate between the experience-based group and the measurement-based group were compared to verify the novel method.

RESULTS: We found a linear correlation between α and β (r = 0.962; P = 0.000). There was no significant correlation between the experience-based group and the measurement-based group in terms of age (P = 0.500), sex (P = 0.397), and side (P = 0.710), but there was a significant statistical difference in the first success rate between the two validation groups (χ2 = 5.808a, P = 0.016).

CONCLUSION: This novel quantitative measurement method for determining the X-ray beam angle of SOV using the horizontal angle of SSSL is feasible.

PMID:34609193 | DOI:10.1177/02841851211043835

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CT Lung Abnormalities after COVID-19 at 3 Months and 1 Year after Hospital Discharge

Radiology. 2021 Oct 5:211746. doi: 10.1148/radiol.2021211746. Online ahead of print.

ABSTRACT

Background Data on the long-term pulmonary sequelae in COVID-19 are lacking. Purpose To assess symptoms and functional impairment and residual pulmonary abnormalities on serial chest CT in COVID-19 survivors discharged from hospital at up to 1-year follow-up. Materials and Methods Adult patients with COVID-19 discharged between March 2020 and June 2020 were prospectively evaluated at 3 months and 1 year, through systematic assessment of symptoms, functional impairments, and thoracic CT as part of the PHENOTYPE study, an observational cohort study in COVID-19 survivors. Lung function testing was limited to participants with CT abnormalities and/or persistent breathlessness. All statistical analyses were performed using Graphpad PRISM Version 9.0 (86) for Mac, GraphPad Software, (www.graphpad.com); Bonferroni corrected p values are stated. Results Eighty participants (mean age, 59 ±13 years; 53 men) were assessed. Persistent breathlessness 37 (46%) and cough 17 (21%) were reported at outpatient review (median 97 days [IQR 86-121]). CT scans in 73 participants post-discharge (median 105 days [IQR 95-141]) revealed persistent abnormalities in 41/73 participants (56%), with ground-glass opacification (35/73 [48%]) and bands (27/73 [37%]) predominating. Unequivocal signs indicative of established fibrosis (i.e. volume loss +/- traction bronchiectasis) were present in 9/73 (12%) participants. Higher admission serum C-reactive protein (mg/L), fibrinogen (g/dl), urea (mmol/L) and creatinine (micromol/L), longer hospital stay (days), older age (years) and requirement for invasive ventilation were associated with CT abnormalities at 3-month follow-up. 32/41 (78%) of participants with abnormal 3-month follow-up CT underwent repeat imaging at a median of 364 (360-366) days, with 26/32 (81%) showing further radiological improvement (median 18% [IQR 10-40%]). Conclusion CT abnormalities were common at 3 months after COVID-19 but with signs of fibrosis in a minority. More severe acute disease was linked with CT abnormalities at 3 months. However, radiologic improvement was seen in the majority at 1-year follow-up. ClinicalTrials.gov Identifier: NCT04459351.

PMID:34609195 | DOI:10.1148/radiol.2021211746

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Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

Foot Ankle Int. 2021 Oct 5:10711007211049193. doi: 10.1177/10711007211049193. Online ahead of print.

ABSTRACT

BACKGROUND: The minimally invasive chevron-Akin (MICA) osteotomy is an increasingly popular technique for the correction of hallux valgus. However, there is a paucity of literature comparing it with traditional open techniques. The purpose of this study was to compare the clinical and radiological outcomes of the MICA osteotomy using a new-generation MICA screw and scarf-Akin osteotomy for hallux valgus correction.

METHODS: Thirty cases of MICA osteotomy were propensity score matched 1:1 with a control group of 30 scarf-Akin osteotomy cases. The groups were matched for age, sex, body mass index, preoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) metatarsophalangeal-interphalangeal (MTP-IP) score, 36-Item Short-Form Health Survey (SF-36) physical component score (PCS) and mental component score (MCS), preoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA), and concomitant procedures. Outcomes were compared at 6 and 24 months postoperatively. Early postoperative VAS scores were also compared.

RESULTS: Both groups demonstrated significant improvements in VAS score, AOFAS score, and SF-36 PCS and MCS at 6 and 24 months postoperatively. For the MICA group, HVA improved from 23.5 to 7.7 degrees, and IMA improved from 13.5 to 7.5 degrees. For the scarf-Akin osteotomy group, HVA improved from 23.7 to 9.3 degrees, and IMA improved from 13.6 to 7.8 degrees. The first 24-hour postoperative VAS score was significantly lower in the MICA group compared with the scarf-Akin group (2.0 ± 2.0 vs 3.4 ± 2.6, P = .029). However, there was no significant difference in clinical or radiological outcomes between the groups at 6 and 24 months.

CONCLUSION: The MICA procedure with the new-generation MICA screw is an attractive option for the correction of hallux valgus, yielding similar midterm radiological and clinical outcomes compared with the well-established scarf-Akin osteotomy. The first 24-hour postoperative VAS score in the MICA group was also statistically lower, although its clinical significance remains to be determined.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PMID:34609174 | DOI:10.1177/10711007211049193

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Contact-adjusted Immunity Levels against SARS-CoV-2 in Korea and Prospects for Achieving Herd Immunity

J Korean Med Sci. 2021 Oct 4;36(38):e272. doi: 10.3346/jkms.2021.36.e272.

ABSTRACT

The proportion of population vaccinated cannot be directly translated into the herd immunity. We have to account for the age-stratified contact patterns to calculate the population immunity level, since not every individual gathers evenly. Here, we calculated the contact-adjusted population immunity against severe acute respiratory syndrome coronavirus 2 in South Korea using age-specific incidence and vaccine uptake rate. We further explored options to achieve the theoretical herd immunity with age-varying immunity scenarios. As of June 21, 2021, when a quarter of the population received at least one dose of a coronavirus disease 2019 (COVID-19) vaccine, the contact-adjusted immunity level was 12.5% under the social distancing level 1. When 80% of individuals aged 10 years and over gained immunity, we could achieve a 58.2% contact-adjusted immunity level. The pros and cons of vaccinating children should be weighed since the risks of COVID-19 for the young are less than the elderly, and the long-term safety of vaccines is still obscure.

PMID:34609093 | DOI:10.3346/jkms.2021.36.e272

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Influence of Women´s Residence Region on Assisted Reproduction Treatments – Experience of a Tertiary Center in Northern Portugal

JBRA Assist Reprod. 2021 Oct 5. doi: 10.5935/1518-0557.20210059. Online ahead of print.

ABSTRACT

OBJECTIVE: Data on the possible influence of women´s region of residence, within the same country, on the outcomes of medically assisted reproduction cycles are scarce. This study aims to assess the impact of the women’s region of residence on the results of in-vitro fertilization cycles.

METHODS: We evaluated in-vitro fertilization cycles between 2010 and 2017, performed in a northern Portugal assisted reproduction center. We defined two groups: Douro Litoral (group 1; n=783), and Trás-os-Montes and Alto Douro (group 2; n=178). We analyzed demographics and cycle-related variables, and we calculated the rates for embryo transfer cycles. We used the Mann-Whitney and Chi-square tests and p<0.05 was considered statistically significant.

RESULTS: We included 961 cycles. The region of residence had no effect on the following variables: women´s age; body mass index; or duration of infertility (p>0.05). Group 2 had a statistical significant lower number of previous cycles than group 1 (1.3±0.5 and 1.5±0.7; p=0.005). In the sub-analysis of cycles with embryo transfer (n=781), group 1 obtained had rates of normal fertilization (62.5% vs. 57.5%; p=0.04), miscarriage rate (30.0 vs. 10.9%; p=0.007), and lower implantation rates compared to group 2 (33.3% vs. 50.0%; p<0.001).

CONCLUSIONS: Women from the region of Trás-os-Montes e Alto Douro had a lower number of previous cycles, compared to those from the Douro Litoral, despite the absence of statistical significant differences in terms of age or infertility duration. These findings reinforce the need to contemplate the sociodemographic and socioeconomic variables in this context.

PMID:34609110 | DOI:10.5935/1518-0557.20210059