Background Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) with active proliferative lesions show a good response to immunosuppressive treatment. Study Design ...Multicenter, prospective, randomized, controlled trial. Setting & Participants 176 patients with IgAN with active proliferative lesions (cellular and fibrocellular crescents, endocapillary hypercellularity, or necrosis), proteinuria with protein excretion ≥ 1.0 g/24 h, and estimated glomerular filtration rate > 30 mL/min/1.73 m2. Intervention Mycophenolate mofetil (MMF) group: MMF, 1.5 g/d, for 6 months and prednisone, 0.4 to 0.6 mg/kg/d, for 2 months and then tapered by 20% per month for the next 4 months; prednisone group: prednisone, 0.8 to 1.0 mg/kg/d, for 2 months and then tapered by 20% per month for the next 4 months. All patients were followed up for another 6 months. Outcomes The primary end point was complete remission rate at 6 and 12 months. Results At baseline, median estimated glomerular filtration rates were 90.2 and 94.3 mL/min/1.73 m2 and mean proteinuria was protein excretion of 2.37 and 2.47 g/24 h in the MMF and prednisone groups, respectively. At 6 months, complete remission rates were 37% (32 of 86 patients) and 38% (33 of 88 patients); the between-group difference was not statistically significant ( P = 0.9). At 12 months, complete remission rates were 48% (35 of 73 patients) and 53% (38 of 72 patients) in the MMF and prednisone groups, respectively; the between-group difference was not statistically significant ( P = 0.6). Incidences of Cushing syndrome and newly diagnosed diabetes mellitus were lower in the MMF group than in the prednisone group. Limitations Not all participants were treated with renin-angiotensin system blockers, relatively short follow-up. Conclusions MMF plus prednisone versus full-dose prednisone did not differ in reducing proteinuria, but patients treated with the former had fewer adverse events in patients with IgAN with active proliferative lesions.
Background A prospective multicenter survey was conducted to assess the rational use of antibiotics in clean and clean-contaminated elective surgical procedures applied in 53 grade III first class ...hospitals in Shandong Province, China, from 2006 to 2011. The survey was designed to examine the prevalence of antibiotic prophylaxis, evaluate the quality of perioperative antibiotic prophylaxis (PAP) prescriptions, and investigate the risk factors associated with inappropriate indication for antibiotic prophylaxis. Methods Medication charts and medical, anesthetic, and nursing records were reviewed. Antibiotic prescriptions were compared with the Chinese National Antibiotic Guideline on indication, antibiotic combination, antibiotic choice, dose, dosing interval, route of administration, timing of first administration, and duration of prophylaxis. Results 14,261 of 14,525 procedures (98.2%) receiving antibiotic prophylaxis. The most frequently encountered noncompliance types were PAP indications (18.6%), duration of prophylaxis (26.7%), and timing of first administration (30.3%). The steps of PAP were justified and correct only in 9.4% of procedures. Risk factors independently associated with inappropriate indication for antibiotic prophylaxis were seen in age, hospital type, hospital size, surgical disciplines, and surgical duration. Conclusion Results showed a significantly high rate of antibiotic prophylaxis in clean and clean-contaminated elective surgery and also a high prevalence of inappropriate indication prescriptions. These findings suggest important areas for intervention and implementation of antibiotic stewardship policies in Shandong Province hospitals.
Physical Properties of 5 Root Canal Sealers Zhou, Hui-min, PhD; Shen, Ya, DDS, PhD; Zheng, Wei, PhD ...
Journal of endodontics,
10/2013, Letnik:
39, Številka:
10
Journal Article
Recenzirano
Abstract Introduction The aim of this study was to evaluate the pH change, viscosity and other physical properties of 2 novel root canal sealers (MTA Fillapex and Endosequence BC) in comparison with ...2 epoxy resin-based sealers (AH Plus and ThermaSeal), a silicone-based sealer (GuttaFlow), and a zinc oxide-eugenol–based sealer (Pulp Canal Sealer). Methods ISO 6876/2001 specifications were followed. The pH change of freshly mixed and set sealers was evaluated during periods of 1 day and 5 weeks, respectively. The viscosity was investigated at different injection rates (72, 10, and 5 mm/min) at room temperature by using a syringe-based system that was based on the Instron 3360 series universal testing system. Results The flow, dimensional change, solubility, and film thickness of all the tested sealers were in agreement with ISO 6876/2001 recommendations. The MTA Fillapex sealer exhibited a higher flow than the Endosequence BC sealer ( P < .05). The MTA Fillapex and Endosequence BC sealers showed the highest film thicknesses among the tested samples. The Endosequence BC sealer exhibited the highest value of solubility, which was in accordance with 3% mass fraction recommended by the ISO 6876/2001, and showed an acceptable dimensional change. The MTA Fillapex and Endosequence BC sealers presented an alkaline pH at all times. The pH of fresh samples of the AH Plus and ThermaSeal sealers was alkaline at first but decreased significantly after 24 hours. The viscosity of the tested sealers increased with the decreased injection rates. Conclusions The tested sealers were pseudoplastic according to their viscosities as determined in this study. The MTA Fillapex and Endosequence BC sealers each possessed comparable flow and dimensional stability but higher film thickness and solubility than the other sealers tested.
Background A sequenced house dust mite (HDM) genome would advance our understanding of HDM allergens, a common cause of human allergies. Objective We sought to produce an annotated Dermatophagoides ...farinae draft genome and develop a combined genomic-transcriptomic-proteomic approach for elucidation of HDM allergens. Methods A D farinae draft genome and transcriptome were assembled with high-throughput sequencing, accommodating microbiome sequences. The allergen gene structures were validated by means of Sanger sequencing. The mite's microbiome composition was determined, and the predominant genus was validated immunohistochemically. The allergenicity of a ubiquinol-cytochrome c reductase binding protein homologue was evaluated with immunoblotting, immunosorbent assays, and skin prick tests. Results The full gene structures of 20 canonical allergens and 7 noncanonical allergen homologues were produced. A novel major allergen, ubiquinol-cytochrome c reductase binding protein–like protein, was found and designated Der f 24. All 40 sera samples from patients with mite allergy had IgE antibodies against rDer f 24. Of 10 patients tested, 5 had positive skin reactions. The predominant bacterial genus among 100 identified species was Enterobacter (63.4%). An intron was found in the 13.8-kDa D farinae bacteriolytic enzyme gene, indicating that it is of HDM origin. The Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed a phototransduction pathway in D farinae , as well as thiamine and amino acid synthesis pathways, which is suggestive of an endosymbiotic relationship between D farinae and its microbiome. Conclusion An HDM genome draft produced from genomic, transcriptomic, and proteomic experiments revealed allergen genes and a diverse endosymbiotic microbiome, providing a tool for further identification and characterization of HDM allergens and development of diagnostics and immunotherapeutic vaccines.
There is an ongoing debate on the safety of digoxin use in patients with atrial fibrillation (AF). To address this issue, the investigators assembled a synthesis of the available evidence on the ...relation between digoxin and all-cause mortality in patients with AF. PubMed and the Embase database were systematically searched to identify all eligible studies examining the association between digoxin use and the mortality risk in AF. Overall hazard ratios and 95% confidence intervals were calculated using the random-effects model. Eleven observational studies were identified that met the inclusion criteria, 5 of which additionally used propensity score matching for statistical adjustment. In total, 318,191 patients were followed up for a mean of 2.8 years. Overall, digoxin use was associated with a 21% increased risk for mortality (hazard ratio 1.21, 95% confidence interval 1.12 to 1.30). Sensitivity analyses found the results to be robust. In the propensity score–matched AF patients, digoxin use was associated with a 17% greater risk for mortality (hazard ratio 1.17, 95% confidence interval 1.13 to 1.22). When the AF cohort was grouped into patients with and without heart failure, the use of digoxin was associated with an increase in mortality in patients with and those without heart failure, and no significant heterogeneity was seen between the groups (p >0.10). In conclusion, the results suggest that digoxin use was associated with a greater risk for mortality in patients with AF, regardless of concomitant heart failure. A well-powered randomized trial is necessary to reveal the true effect of digoxin.
Abstract Environment-responsive near-infrared (NIR) aza-BODIPY dyes capable of fluorescence quenching in water were explored to visualize the in vivo fate of model lipid-based nanocarriers, solid ...lipid nanoparticles (SLNs). The water-quenching effect of the dyes was confirmed to be sensitive and remained stable for at least 24 h. In vitro lipolysis measured by fluorescence quenching completed within 20 min, which was in correlation with alkaline compensation results. In vivo live imaging indicated predominant digestion of SLNs within 2 h and complete digestion within 4 h, which correlated well to in vitro data. Rekindling of quenched dyes by mixed micelles was observed in vitro , but not in vivo . In sharp contrast, SLNs encapsulating another NIR dye DiR showed persistent fluorescence both in vitro and in vivo despite significant lipolysis. It was envisaged that water-quenching fluorescence dyes can be used as probes to monitor the in vivo fate of lipid-based nanocarriers. From the Clinical Editor Lipid-based drug delivery systems can provide an excellent nanocarrier platform for the delivery of poorly water-soluble drugs. Nonetheless, the mechanism of oral absorption and subsequent kinetics is poorly understood. In this article, the authors studied the novel use of near-infrared (NIR) aza-BODIPY dyes to visualize the fate of these lipid-based nanocarriers. The positive finding means that this approach may be useful for in-vivo monitoring of lipid-based nanocarriers.
Abstract Background Esculentoside A (EsA) is a saponin isolated from the Chinese herb Phytolacca esculenta . In our study, we sought to investigate the protective effects of EsA on lipopolysaccharide ...(LPS)-induced acute lung injury (ALI) in mice. Materials and methods To determine the effects of EsA on the reduction of histopathologic changes in mice with ALI, inflammatory cell count in bronchoalveolar lavage fluid (BALF) and lung wet-to-dry weight ratio were measured in LPS-challenged mice, and lung histopathologic changes observed via paraffin section were assessed. Next, cytokine production induced by LPS in BALF was measured by enzyme-linked immunosorbent assay. To further study the mechanism of EsA protective effects on ALI, IκBa, p38, and extracellular signal receptor-activated kinase pathways were investigated in lung tissue of mice with ALI. Results In the present investigation, EsA showed marked effects by reducing inflammatory infiltration, thickening of the alveolar wall, and pulmonary congestion. Levels of tumor necrosis factor α and interleukin 6 elevated by LPS were significantly decreased in BALF in EsA-pretreated ALI model. Furthermore, EsA significantly suppressed phosphorylation of IκBa, p38, and extracellular signal receptor-activated kinase. Conclusions Taken together, our results suggest that EsA suppressed inflammatory responses in LPS-induced ALI through inhibition of the nuclear factor kappa B and mitogen activated protein kinase signaling pathways. EsA may be a promising potential preventive agent for ALI treatment.
Abstract Introduction The aim of this study was to investigate the structure and mechanical properties of newly developed controlled memory (CM) nickel-titanium wires used in the manufacture of ...rotary endodontic instruments. Methods The composition and the phase transformation behavior of both types of wires were examined by x-ray energy dispersive spectroscopy and differential scanning calorimetry, respectively. Conventional superelastic (SE) nickel-titanium wire was used as a control. The mechanical properties of the wires at selected temperatures (room temperature, 37°C, and 60°C) were evaluated with tensile, cyclic tensile, and cantilever bending tests by using an Instron 3365 universal testing machine. The data of austenitic transformation finishing temperature (Af ) were analyzed statistically by using 1-way analysis of variance test at a significance level of P < .05. Results The raw CM wires contained a nickel content of 50.7% ± 0.5% and possessed a relatively higher Af than SE wires ( P < .05). The critical plateau stress and ultimate tensile strength of the CM wires were lower than they were for the SE wires, but the maximum strain before fracture of the CM wires (58.4% ± 7.5% to 84.7% ± 6.8%) was more than 3 times higher than it was for SE wires (16.7% ± 3.8% to 27.5% ± 5.4%). The maximum strain of the CM wires with a diameter of 1.22 mm tested at room temperature (23°C ± 2°C) was up to 84% ± 6.4%. CM wires were not SE at either room temperature or 37°C; however, they exhibited superelasticity when heated to 60°C. Conclusions The raw CM wires exhibited different phase transformation behavior and mechanical properties when compared with SE wires, attributing to the special heat treatment history of CM wires. This study suggested greater flexibility of endodontic instruments manufactured with CM wires than similar instruments made of conventional SE wires.
Abstract Background Puerarin is the most abundant isoflavonoid in kudzu root. It has been used to treat angina pectoris and myocardial infarction clinically. However, little is known about the effect ...of puerarin on cardiac hypertrophy. Methods Aortic banding (AB) was performed to induce cardiac hypertrophy in mice. Puerarin premixed in diets was administered to mice after one week of AB. Echocardiography and catheter-based measurements of hemodynamic parameters were performed at 7 weeks after starting puerarin treatment (8 weeks post-surgery). The extent of cardiac hypertrophy was also evaluated by pathological and molecular analyses of heart samples. Cardiomyocyte apoptosis was assessed by measuring Bax and Bcl-2 protein expression and terminal deoxynucleotidyl transferase dUTP nick end labeling staining. In addition, the inhibitory effect of puerarin (1 μM, 5 μM, 10 μM, 20 μM, 40 μM) on mRNA expression of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in Ang II (1 μM)-stimulated H9c2 cells was investigated using quantitative real-time reverse transcription-polymerase chain reaction. Results Echocardiography and catheter-based measurements of hemodynamic parameters at 7 weeks revealed the amelioration of systolic and diastolic abnormalities. Puerarin also decreased cardiac fibrosis in AB mice. Moreover, the beneficial effect of puerarin was associated with the normalization in gene expression of hypertrophic and fibrotic markers. Further studies showed that pressure overload significantly induced the activation of phosphoinositide 3-kinase (PI3K)/Akt signaling and c-Jun N-terminal kinase (JNK) signaling, which was blocked by puerarin treatment. Cardiomyocyte apoptosis and induction of Bax in response to AB were suppressed by puerarin. Furthermore, the increased mRNA expression of ANP and BNP induced by Ang II (1 μM) was restrained to a different extent by different concentrations of puerarin. Conclusion Puerarin may have an ability to retard the progression of cardiac hypertrophy and apoptosis which is probably mediated by the blockade of PI3K/Akt and JNK signaling pathways.
Previous studies have demonstrated that biological aging has a negative influence on the therapeutic effects of mesenchymal stem cells (MSCs)-based therapy. Using a rat myocardial infarction (MI) ...model, we tested the hypothesis that silent mating type information regulation 2 homolog 1 (SIRT1) may ameliorate the phenotype and improve the function of aged MSCs and thus enhance the efficacy of aged MSCs-based therapy.
Sixty female rats underwent left anterior descending coronary artery ligation and were randomly assigned to receiving: intramyocardial injection of cell culture medium (DMEM group); SIRT1 overexpression vector-treated aged MSCs (SIRT1-aged MSCs group) obtained from aged male SD rats or empty vector-treated aged MSCs (vector-aged MSCs group). Another 20 sham-operated rats that underwent open-chest surgery without coronary ligation or any other intervention served as controls.
SIRT1-aged MSC group exhibited enhanced blood vessel density in the border zone of MI hearts, which was associated with reduced cardiac remodeling, leading to improved cardiac performance. Consistent with the in vivo data, our in vitro experiments also demonstrated that SIRT1 overexpression ameliorated aged MSCs senescent phenotype and recapitulated the pro-angiogenesis property of MSCs and conferred the anti-stress response capabilities, as indicated by increases in pro-angiogenic factors, angiopoietin 1 (Ang1) and basic fibroblast growth factor (bFGF), expressions and a decrease in anti-angiogenic factor thrombospondin-1 (TBS1) at mRNA levels, and increases in Bcl-2/Bax ratio at protein level.
Up-regulating SIRT1 expression could enhance the efficacy of aged MSCs-based therapy for MI as it relates to the amelioration of senescent phenotype and hence improved biological function of aged MSCs.
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