Bi2Te3 based alloy nanosheet (NS)/poly(3,4-ethylenedioxythiophene):poly(4-styrenesulfonate) (PEDOT:PSS) composite films were prepared separately by spin coating and drop casting techniques. The drop ...cast composite film containing 4.10 wt % Bi2Te3 based alloy NSs showed electrical conductivity as high as 1295.21 S/cm, which is higher than that (753.8 S/cm) of a dimethyl sulfoxide doped PEDOT:PSS film prepared under the same condition and that (850–1250 S/cm) of the Bi2Te3 based alloy bulk material. The composite film also showed a very high power factor value, ∼32.26 μWm–1 K–2. With the content of Bi2Te3 based alloy NSs increasing from 0 to 4.10 wt %, the electrical conductivity and Seebeck coefficient of the composite films increase simultaneously.
Summary
Background
Clostridium difficile infection is a major cause of nosocomial diarrhoea.
Aim
To evaluate long‐term (≥90 days) efficacy and safety of faecal microbiota transplantation for C. ...difficile infection and explore the factors affecting the faecal microbiota transplantation outcomes.
Methods
MEDLINE, the Cochrane Library and EMBASE were searched and only observational studies that utilised faecal microbiota transplantation for C. difficile infection with long‐term follow‐up duration (≥90 days) were included. Primary cure rate, overall recurrence rate and early (<90 days) and late (≥90 days) recurrence rate were calculated.
Results
Eighteen observational studies with 611 patients were included. The primary cure rate was 91.2% (95% confidence interval, CI 86.7–94.8%). The overall recurrence rate was 5.5% (95% CI 2.2–10.3%). The early recurrence rate and late recurrence rate were 2.7% (95% CI 0.7–6.0%) and 1.7% (95% CI 0.4–4.2%) respectively. Most adverse events were expected, short‐lived, self‐limited and manageable. The association between faecal microbiota transplantation therapy and adverse events such as inflammatory bowel disease flare, infectious disease and autoimmune disease was a concern but remained insignificant. Old age (≥65 years) was identified as a risk factor for after faecal microbiota transplantation therapy. Upper gastrointestinal administration also results in less frequent primary cure.
Conclusions
Faecal microbiota transplantation seems to be a highly effective and robust therapy for recurrent C. difficile infection. However, more quality studies, such as randomised controlled trials and cohort studies with control groups, are needed to confirm its long‐term efficacy and safety.
Dental caries is a highly prevalent diet-related disease and is a major public health problem. A goal of modern dentistry is to manage non-cavitated caries lesions non-invasively through ...remineralization in an attempt to prevent disease progression and improve aesthetics, strength, and function. Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to the tooth to promote ion deposition into crystal voids in demineralized enamel, to produce net mineral gain. Recently, a range of novel calcium-phosphate-based remineralization delivery systems has been developed for clinical application. These delivery systems include crystalline, unstabilized amorphous, or stabilized amorphous formulations of calcium phosphate. These systems are reviewed, and the technology with the most scientific evidence to support its clinical use is the remineralizing system utilizing casein phosphopeptides to stabilize and deliver bioavailable calcium, phosphate, and fluoride ions. The recent clinical evidence for this technology is presented and the mechanism of action discussed. Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization show promise for the non-invasive management of dental caries.
Summary
We performed a systematic review and meta-analysis of randomized clinical trials. Early administration of bisphosphonates (BPs) after surgery did not appear to delay fracture healing time ...either radiologically or clinically. Furthermore, the anti-resorptive efficacy of BPs given immediately after surgical repair should positively affect the rate of subsequent fractures.
Introduction
Bisphosphonates (BPs) are widely used in the prophylaxis and treatment of osteoporosis. However, early administration of BPs after surgical repair of a fracture may limit the reserve capacity of bone to heal. The aim of this review and meta-analysis was to analyze the benefits and adverse effects of early administration of BPs and give recommendations regarding when BPs should be utilized.
Methods
We identified randomized controlled trials comparing the early administration of BPs to placebo, delayed BP treatment, or no therapy in adult patients after surgery. The search was performed in PubMed, the Cochrane Library, and Embase.
Results
Ten studies with 2888 patients were included. Four trials used alendronate, three trials used zoledronic, two trials used risedronate, and one trial used etidronate. Early administration of BPs was considered less than 3 months after surgery. Patients treated with BP therapy had no significant differences in radiological fracture healing times compared with patients in the control group (mean difference MD 0.47, 95 % confidence interval CI −2.75 to 3.69). There were also no significant differences in the rate of delay or nonunion of fracture healing (odds ratio OR 0.98, 95 % CI 0.64 to 1.50). However, the bone mineral density (BMD) of total hips did significantly improve after 12 months of treatment with BPs. And most bone turnover markers of patients in the study group were significantly decreased.
Conclusions
Early administration of BPs after surgery did not appear to delay fracture healing time either radiologically or clinically. Furthermore, according to the changes in BMD and bone turnover markers, the anti-resorptive efficacy of BPs given immediately after surgical repair should positively affect the rate of subsequent fractures.
Summary Intervertebral disc (IVD) degeneration is a complicated process that involves both age-related change and tissue damage caused by multiple stresses. In a degenerative IVD, cellular senescence ...accumulates and is associated with reduced proliferation, compromised self-repair, increased inflammatory response, and enhanced catabolic metabolism. In this review, we decipher the senescence mechanism of IVD degeneration (IVDD) by interpreting how aging coordinates with age-related, microenvironment-derived stresses in promoting disc cell senescence and accelerating IVDD. After chronic and prolonged replication, cell senescence may occur as a natural part of the disc aging process, but can potentially be accelerated by growth factor deficiency, oxidative accumulation, and inflammatory irritation. While acute disc injury, excessive mechanical overloading, diabetes, and chronic tobacco smoking contribute to the amplification of senescence-inducing stresses, the avascular nature of IVD impairs the immune-clearance of the senescent disc cells, which accumulate in cell clusters, demonstrate inflammatory and catabolic phenotypes, deteriorate disc microenvironment, and accelerate IVDD. Anti-senescence strategies, including telomerase transduction, supply of growth factors, and blocking cell cycle inhibitors, have been shown to be feasible in rescuing disc cells from early senescence, but their efficiency for disc regeneration requires more in vivo validations. Guidelines dedicated to avoiding or alleviating senescence-inducing stresses might decelerate cellular senescence and benefit patients with IVD degenerative diseases.
The tourniquet is a common medical instrument used in total knee arthroplasty (TKA). However, there has always been a debate about the use of a tourniquet and there is no published meta-analysis to ...study the effects of a tourniquet on blood loss in primary TKA for patients with osteoarthritis.
We performed a literature review on high-quality clinical studies to determine the effects of using a tourniquet or not on blood loss in cemented TKA. PubMed, Web of Science, MEDLINE, Embase, and the Cochrane Library were searched up to November 2018 for relevant randomized controlled trials (RCTs). We conducted a meta-analysis following the guidelines of the Cochrane Reviewer's Handbook. We used the Cochrane Collaboration's tool for assessing the risk of bias of each trial. The statistical analysis was performed with Review Manager statistical software (version 5.3).
Eleven RCTs involving 541 patients (541 knees) were included in this meta-analysis. There were 271 patients (271 knees) in the tourniquet group and 270 patients (270 knees) in the no tourniquet group. The results showed that using a tourniquet significantly decreased intraoperative blood loss (P < 0.002), calculated blood loss (P < 0.002), and the time of operation (P < 0.002), but tourniquet use did not significantly decrease postoperative blood loss (P > 0.05), total blood loss (P > 0.05), the rate of transfusion (P > 0.05), and of deep vein thrombosis (DVT) (P > 0.05) in TKA.
Using a tourniquet can significantly decrease intraoperative blood loss, calculated blood loss, and operation time but does not significantly decrease the rate of transfusion or the rate of DVT in TKA. More research is needed to determine if there are fewer complications in TKA without the use of tourniquets.
BACKGROUND
Knowing predictors of pregnancy in IVF is helpful for clinicians to individualize the treatment plans and improve patient counseling and for patients to decide whether to undergo ...infertility treatment. The aim of the study was to identify independent predictors of the chance of clinical pregnancy after a completed IVF/ICSI cycle (fresh plus cryopreserved embryos transferred from one stimulated cycle) and to compare the predictive value of important predictors identified.
METHODS
This was a single center, retrospective study of 2450 infertile women undergoing their first IVF treatment between 2002 and 2007. A bootstrapping stepwise variable selection algorithm was performed to identify independent predictors of clinical pregnancy chance from a list of 27 candidate variables. Multivariable logistic regression was used for assessing the effects of predictors. Proportion of explained variation analysis and concordance index were adopted to compare the predictive value of factors.
RESULTS
The following nine independent predictors were included in the final multivariable model: total number of good-quality embryos, total number of embryos, age, antral follicle count, fertilization rate, duration of infertility, endometrial thickness, number of 10–14-mm follicles and progesterone level on the day of hCG injection. The model was cross-validated internally in the training data and validated externally in an independent data with robust performance. The stratified analysis demonstrated that the total number of good-quality embryos was a better predictor of clinical pregnancy chance after a completed IVF/ICSI cycle than age for women <40 years, whereas age was a better predictor for women ≥40 years. The restricted cubic spline analysis revealed the relationship between the total number of good-quality embryos and log-odds of achieving a clinical pregnancy was nonlinear.
CONCLUSIONS
Quality and quantity of the whole embryos are the two most important predictors of the cumulative outcome in IVF/ICSI among independent predictors indentified. The importance of embryo quality on cumulative outcome in IVF/ICSI increases with increasing age.
Chromatin regulatory mechanisms play a major role in the control of gene expression programs during normal development and are disrupted in specific disease states, particularly in cancer. Important ...mediators of chromatin regulatory processes can broadly be classified into writers, erasers, and readers of covalent chromatin modifications that modulate eukaryotic gene transcription and maintain the integrity of the genome. The reversibility and disease-specific nature of these chromatin states make these regulators attractive therapeutic targets. As such, there is an ever-increasing number of candidate therapies aimed at targeting cancer-associated chromatin states that are in various stages of preclinical and clinical development. In this review, we discuss recent advances that have been made in the rational therapeutic targeting of chromatin regulatory mechanisms and highlight certain cancers where there is a specific rationale to assess these therapeutic approaches.
In this review, Cai et al. discuss recent advances and strategies in the rational therapeutic targeting of chromatin regulatory mechanisms with a focus on therapies for cancer.
Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) slows the progression of caries and remineralizes enamel subsurface lesions. The aim of this study was to determine the ability of CPP-ACP ...to increase the incorporation of fluoride into plaque and to promote enamel remineralization in situ. Randomized, double-blind, cross-over studies involved mouthrinses and dentifrices containing CPP-ACP and fluoride. The mouthrinses were used for 60 sec, three times/day for 5 days, and supragingival plaque was collected and analyzed for F. The dentifrices were rinsed as a water slurry for 60 sec four times/day for 14 days in an in situ model. The addition of 2% CPP-ACP to the 450-ppm-F mouthrinse significantly increased the incorporation of fluoride into plaque. The dentifrice containing 2% CPP-ACP produced a level of remineralization similar to that achieved with a dentifrice containing 2800 ppm F. The dentifrice containing 2% CPP-ACP plus 1100 ppm F was superior to all other formulations.
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