Acceso y adhesión a proceso de intervención psicosocial diferenciado para los servicios y sistemas de salud en varones gay adultos viviendo con el VIH, Paraguay, 2022 / Access and adherence to a differentiated psychosocial intervention process for health services and systems in adult gay men living with HIV, Paraguay, 2022

Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

Effect of electrochemically dealloying Ti6Al4V abutments on human gingival fibroblasts / 口腔疾病防治

Objective@#To investigate the effects of electrochemically dealloying of Ti6Al4V abutments on human gingival fibroblasts (HGFs) and to provide experimental evidence for surface modification of implant abutments.@*Methods@#The samples were divided into an NC group (negative control, no other treatment on a smooth surface), an NM-1 group (nanomesh-1, electrochemical dealloying treatment in 1 mol/L NaOH 1 h on 2 V voltage), and an NM-2 group (nanomesh-2, electrochemical dealloying treatment in 5 mol/L NaOH 1 h on 2 V voltage). The surface morphologies of the samples and the adhesion of HGFs on the sample surfaces were observed with scanning electron microscopy (SEM). The surface hydrophilicities of the samples were measured with a contact angle measuring instrument. The proliferation of HGFs on the different samples were evaluated with CCK-8, and the expression of adhesion-related genes, including collagen Ⅰ (COL1A1), collagen Ⅲ (COL3A1), fibronectin 1 (FN1), focal adhesion kinase (FAK), vinculin (VCL), integrin α2 (ITGA2), and integrin β1 (ITGB1), on the different samples was measured with qRT-PCR. The expression of vinculin on the surfaces of HGFs was observed via confocal laser scanning microscopy (CLSM) after immunofluorescent staining. Collagen fiber secretion and syntheses of HGFs from different samples were evaluated via Sirius red staining.@*Results@#SEM revealed the formation of ordered and uniform three-dimensional mesh structures on the surfaces of the NM-1 and NM-2 groups, with grid diameters of approximately 30 nm for the NM-1 group and approximately 150 nm for the NM-2 group. Compared with that of the NC group, the water contact angles of the NM-1 group and NM-2 groups were significantly lower (P<0.000 1). Cell proliferation in the NM-1 group was significantly greater than that in the NC group (P<0.01). Moreover, there was no significant difference in the water contact angles or cell proliferation between the NM-1 group and the NM-2 group. SEM revealed that HGFs were adhered well to the surfaces of all samples, while the HGFs in the NM-1 and NM-2 groups showed more extended areas, longer morphologies, and more developed pseudopodia than did those in the NC group after 24 h. qRT-PCR revealed that the expression levels of the adhesion-related genes COL1A1, COL3A1, FN1, FAK and VCL in the NM-1 group were significantly greater than those in the NC and NM-2 groups (P<0.01). The expression of vinculin protein in the NM-1 group was the highest, and the number of focal adhesions was greatest in the NM-1 group (P<0.01). The results of Sirius red staining showed that the NM-1 group had the highest secretion and syntheses of collagen fibers (P<0.000 1).@*Conclusion@#The three-dimensional nanomechanical structure of Ti6Al4V modified by electrochemical dealloying promoted the adhesion, proliferation, collagen fiber secretion and syntheses of HGFs, and electrochemical dealloying of Ti6Al4V with a grid diameter of approximately 30 nm obviously promoted HGF formation.

Research progress on association between macrophages and ischemia-reperfusion injury / 器官移植

Ischemia-reperfusion injury (IRI) is an extremely complicated pathophysiological process, which may occur during the process of myocardial infarction, stroke, organ transplantation and temporary interruption of blood flow during surgery, etc. As key molecules of immune system, macrophages play a vital role in the pathogenesis of IRI. M1 macrophages are pro-inflammatory cells and participate in the elimination of pathogens. M2 macrophages exert anti-inflammatory effect and participate in tissue repair and remodeling and extracellular matrix remodeling. The balance between macrophage phenotypes is of significance for the outcome and treatment of IRI. This article reviewed the role of macrophages in IRI, including the balance between M1/M2 macrophage phenotype, the mechanism of infiltration and recruitment into different ischemic tissues. In addition, the potential therapeutic strategies of targeting macrophages during IRI were also discussed, aiming to provide reference for alleviating IRI and promoting tissue repair.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Preparation of an amino hybrid mesoporous silica-based nanotopography protective coating on a titanium implant surface and evaluation of its osteogenic effect / 口腔疾病防治

Objective@#To deposit degradable amino-hybrid mesoporous silica (AHMS) in situ on the surface of titanium nanotube (TNT) and explore its protective effect on nanomorphology and osteogenesis.@*Methods@#TNT and TNT@AHMS were sequentially prepared via an anodizing method: the oil-water two-phase method (experimental group) and the acid-etched titanium method [control group (Ti)]. The parameters for synthesis were explored by changing the silicon source dosage ratio (3∶1, 1∶1, 1∶3); the surface morphology was observed by scanning electron microscope(SEM), hydrophilicity was detected by Water Contact Angle Tester, elemental composition was detected by X-ray photoelectron spectroscopy (XPS); nanoindentation test and ultrasonic oscillator were used to observe the morphological holding effect as mechanical strength of TNT@AHMS in vitro; simulated immersion experiments in vitro was used to observe the degradation behavior of the material. the MC3T3-E1 cell line was used to observe the effect of cell adhesion, proliferation and differentiation on the material; and an SD rat femoral implant model and micro-CT were used to verify the protective effect and osseointegration effect of AHMS on TNT morphology.@*Results@#The morphologies of TNT and TNT@AHMS were successfully prepared, and the silicon source ratio was 1:3. SEM showed that the titanium nanotubes were uniformly covered with AHMS coating, and the mesoporous pore size was about 4 nm. After AHMS was incorporated, the surface of the material was hydrophilic (12.78°), the presence of amino groups (NH2-) was detected, the material was completely degraded within 12 h in vitro, and the active morphology of the TNT was re-exposed with a cumulative silicon release of 10 ppm. Nanoindentation test showed that TNT@AHMS exhibited more ideal surface mechanical strength. SEM revealed that TNT maintains its own morphology under the protection of AHMS, and the TNT group suffered severe exfoliation. In addition, the early adhesion and proliferation rates, ALP activity, and bone volume fraction of cells on the TNT@AHMS surface 4 weeks after implantation were significantly higher than those in the TNT group.@*Conclusion@#By depositing AHMS on the surface of TNT, the nanotopography can be protected. It not only prevents the active base topography from exerting subsequent biological effects but also further endows the material with the ability to promote bone regeneration, laying a foundation for the future development of nanotopography-modified titanium implants.

Gene de virulência oipA de Helicobacter pylori como marcador molecular de gastropatias severas / Helicobacter pylori oipa virulence gene as a molecular marker of severe gastropathies

ABSTRACT Background: Helicobacter pylori is an etiologic agent of gastroduodenal diseases. The microorganism, considered a type I carcinogen, affects about 50% of the global population. H. pylori virulence factors are determinant for the clinical outcome of the infection. The outer inflammatory protein A (oipA) gene encodes an outer membrane adhesin and is related to severe gastropathies, such as gastric cancer. Objective: The aim of this study was to evaluate the association of the oipA gene with the severity of gastroduodenal diseases in dyspeptic patients in region Central Brazil. Methods: The polymerase chain reaction (PCR) was used to determine the presence of H. pylori. Samples positives were used for molecular screening of the oipA gene. Gastropathies were categorized as non-severe and severe diseases. Results: Approximately 68% of patients had H. pylori and 36% were infected with H. pylori oipA+ strains. Infection was significantly associated in patients aged over 44 years (P=0.004). However, there was no association between oipA and patients' age (P=0.89). Approximately 46% of patients infected with oipA+ strains had some severe illness. Gastric adenocarcinoma was the most frequent severe gastropathy. The H. pylori oipA genotype was inversely associated with the severity of gastroduodenal diseases (OR=0.247, 95%CI: 0.0804-0.7149 and P=0.007). Conclusion: The characterization of possible molecular markers will contribute to personalized medicine, impacting the prognosis of patients.

RESUMO Contexto: Helicobacter pylori é um agente etiológico de doenças gastroduodenais. O microrganismo, considerado cancerígeno tipo I, afeta cerca de 50% da população mundial. Os fatores de virulência do H. pylori são determinantes para o desfecho clínico da infecção. O gene da proteína inflamatória externa A (oipA) codifica uma adesina da membrana externa e está relacionado a gastropatias severas, como o câncer gástrico. Objetivo: O objetivo deste estudo foi avaliar a associação do gene oipA com a gravidade das doenças gastroduodenais em pacientes dispépticos na região Brasil Central. Métodos: A reação em cadeia da polimerase (PCR) foi utilizada para determinar a presença de H. pylori. Amostras positivas foram utilizadas para triagem molecular do gene oipA. As gastropatias foram categorizadas como doenças não severas e severas. Resultados: Aproximadamente 68% dos pacientes apresentaram H. pylori e 36% estavam infectados com cepas H. pylori oipA+. A infecção foi significativamente associada em pacientes com idade superior a 44 anos (P=0,004). No entanto, não houve associação entre oipA e a idade dos pacientes (P=0,89). Aproximadamente 46% dos pacientes infectados com cepas oipA+ tiveram alguma doença severa. O adenocarcinoma gástrico foi a gastropatia severa mais frequente. O genótipo oipA de H. pylori foi inversamente associado à gravidade das doenças gastroduodenais (OR=0,247, IC95%: 0,0804-0,7149 P=0,007). Conclusão: A caracterização de possíveis marcadores moleculares contribuirá para a medicina personalizada, impactando no prognóstico dos pacientes.

Caracterización y evaluación de adherencia al programa Get With The Guidelines en pacientes con insuficiencia cardíaca aguda en un hospital de Bogotá, 2016-2018: Cohorte HUN-ICA / Characterization and evaluation of adherence to the Get With The Guidelines-Heart Failure program in patients with acute heart failure in a hospital in Bogotá, 2016-2018: HUN-ICA cohort

Introducción: la adherencia a estándares de manejo en insuficiencia cardiaca como la iniciativa Get With the Guidelines (GWTG) de la AHA puede disminuir los reingresos y mortalidad. Objetivo: describir las características clínicas de pacientes hospitalizados por insuficiencia cardiaca aguda y evaluar la adherencia a estándares de práctica clínica del programa "Get With The Guidelines", en un hospital universitario de Bogotá. Materiales y métodos: estudio observacional de la cohorte retrospectiva HUN-ICA correspondiente a 493 pacientes adultos hospitalizados entre abril 2016 y diciembre 2018 por insuficiencia cardiaca aguda, se registraron variables clínicas, tratamiento, mortalidad, reingresos y se evaluó adherencia a estándares de calidad del programa GWTG. Resultados: 52,1 % de la población fueron mujeres con una media de edad 75 años y el 67,8 % con FEVI >40 %. La etiología más común fue hipertensiva 58,5 % y la mayor causa de descompensación infecciosa (28,8 %). Aumentó la adherencia al uso de betabloqueadores en pacientes con fracción de eyección reducida al egreso de 46 % respecto al ingreso y al uso de antagonistas de receptor mineralocorticoide en pacientes con FEVI reducida de 61,1 %. Discusión: la cohorte evaluada presentó un perfil hemodinámico, clínico y adherencia en el manejo similar a cohortes nacionales. Las dosis subóptimas de la medicación al egreso justifican la necesidad de clínicas ambulatorias de insuficiencia cardíaca. Conclusiones: Se encontró menor adherencia para uso y dosis óptimas de betabloqueadores y antagonista mineralocorticoide que la de la cohorte GWTG, con incremento del uso de terapia farmacológica entre el ingreso y el egreso hospitalario.

Introduction: adherence to management standards in heart failure such as the AHA´s Get With the Guidelines-Heart failure initiative can reduce readmissions and mortality. Objective: To describe the clinical characteristics of patients hospitalized for acute heart failure and to assess adherence to program quality standards of the Get With The Guidelines Program in a university hospital in Bogotá. Methods: observational, descriptive and retrospective HUN-ICA cohort study. 493 adult patients hospitalized for acute heart failure, between April 2016 to December 2018. Clinical variables, treatment, mortality, readmissions and adherence to program quality standards defined by the GWTG program criteria were evaluated. Results: 52,1 % of the population were women, mean age was 75 years, (67,8 %) cases of heart failure with LVEF > 40 %. The most common etiology of heart failure was hypertensive (58,5 %). The most frequent etiology of decompen- sation was infectious (28,8 %). Adherence to beta-blockers use increased in patients with reduced ejection fraction at discharge of 46 %, and to the use of mineralocorticoid receptor antagonists in 61,1 %, compared to admission. Discussion: the evaluated cohort presented a hemodynamic, clinical profile and adherence similar to colombian cohorts. Suboptimal doses of medication upon discharge justify the need for outpatient heart failure clinics. Conclusions: lower adherence for use and optimal doses of beta-blockers and mineralocorticoid receptor antagonists than GWTG cohort was found, with increased use of guidelines recommended pharmacological therapy between hospital admission and discharge.

Bond strength comparison among 10-MDP-containing and non-10-MDP-Containing adhesives in different degrees of dental fluorosis / Comparación de fuerza de unión entre adhesivos que contienen y no contienen 10-MDP en diferentes grados de fluorosis dental

Dental fluorosis can cause changes in the enamel surface, conditioning its functionality and esthetics. The application of dental adhesives is a treatment option; however, their use on fluorotic teeth can result in limitations. The aim of this study was to compare the shear bond strength of two different adhesives, one with 10-MDP and one without 10-MDP, in different degrees of dental fluorosis.This is an in vitro study on dental enamel samples, a total of 180 samples with the inclusion criteria were treated, randomly divided into two groups of 90, according to the type of dental adhesive, where each group was again divided into three groups of 30 samples, representing different degrees of dental fluorosis according to the Thylstrup-Fejerskov index (Group I: TF1 and TF2; Group II: TF3; Group III: TF4). Normality tests, two-factor ANOVA, and post-hoc tests were used to determine differences between the groups, with a significance level of 95%. As results, a statistically significant difference was shown between the use of dental adhesive with 10-MDP and the three groups of dental fluorosis (p=0.011), in addition, a Tukey post-hoc test on the groups treated with 10-MDP adhesive revealed a statistically significant difference between group I versus group II, and group I versus group III, (p=<0.05). It is concluded that the use of adhesive systems with 10-MDP presents a better shear bond strength on enamel with dental fluorosis grades I and II in the Thylstrup-Fejerskov index.

La fluorosis dental puede ocasionar cambios en la superficie del esmalte, condicionando su funcionalidad y estética, la aplicación de adhesivos dentales es una opción de tratamiento, sin embargo, su uso en dientes fluoroticos puede resultar en limitaciones. El objetivo de este estudio consistió en comparar la fuerza de adhesión a la cizalladura de dos diferentes adhesivos, uno con 10-MDP y otro sin 10-MDP, en diferentes grados de fluorosis dental. Se trata de un estudio in vitro en muestras de esmalte dental, un total de 180 muestras con los criterios de inclusión fueron tratadas, aleatoriamente divididas en dos grupos de 90, de acuerdo al tipo de adhesivo dental, donde cada grupo fue dividido nuevamente en tres grupos de 30 muestras, representando diferentes grados de fluorosis dental según el índice de Thylstrup- Fejerskov (Grupo I: TF1 y TF2; Grupo II: TF3; Grupo III: TF4). Para determinar diferencias entre los grupos se utilizaron pruebas de normalidad, ANOVA de dos factores, y pruebas post-hoc, con un nivel de significancia de 95%. Como resultados, se mostró una diferencia estadísticamente significativa entre el uso de adhesivo dental con 10- MDP y los tres grupos de fluorosis dental (p=0.011), además, una prueba post hoc de Tukey sobre los grupos tratados con adhesivo 10-MDP revelaron una diferencia estadísticamente significativa entre el grupo I frente al grupo II, y el grupo I frente al grupo III, (p=<0.05) Se concluye que el uso de sistemas adhesivos con 10-MDP presentan una mejor resistencia de adhesión al cizallamiento en esmalte con grados de fluorosis dental I y II en el índice de Thylstrup-Fejerskov

Revoluções na Odontologia / Revoluciones en la Odontología

Quais as mudanças e descobertas que revolucionaram a Odontologia ao longo do tempo? A adesão, osseointegração, ortodontia e a tecnologia CAD/CAM estão entre essas grandes mudanças. Neste primeiro editorial de 2023 trazemos essa reflexão para o período que se inicia.

What changes and discoveries have revolutionized dentistry over time? Adhesion, osseointegration, orthodontics and CAD/CAM technology are among these major changes. In this first editorial of 2023, we bring this reflection to the period that begins.

Construção e validação da escala de verificação da adesão às recomendações das Diretrizes Brasileiras de Ventilação Mecânica / Construction and validation of the scale for verifying adherence to the recom-mendations of The Brazilian Guidelines For Mechanical Ventilation / Construcción y validación de la escala para verificar la adherencia a las recomenda-ciones de Las Directrices Brasileñas Sobre Ventilación Mecánica

Objetivo: construir e validar uma escala de verificação da adesão às recomendações das Diretrizes Brasileiras de Ventilação Mecânica por profissionais da saúde. Método: estudo metodológico, conduzido no período entre setembro e dezembro de 2019 em um hospital público com 87 pacientes. Para a validação de conteúdo, adotou-se o Índice de Validação de Conteúdo; para a validade de critério, o Coeficiente de Correlação de Pearson; para a consistência interna, o alfa de Cronbach; e, para a confiabilidade interobservador, o Coeficiente Kappa e o Coeficiente de Correlação Intraclasse. Resultados: a escala identificou uma validade de conteúdo e consistência interna aceitável. A correlação de Pearson indicou uma correlação do escore de adesão com a saturação (r = 0,31; p≤0,005), o escore médio para o observador A e B resultou, respectivamente, em 88,89(±5,23) e 88,86(±5,34), e o intervalo de confiança foi de 0,96. Conclusão: a escala apresentou validade e confiabilidade para verificar a adesão às Diretrizes Brasileiras de Ventilação Mecânica dos profissionais.(AU)

Objective: to construct and validate a scale for verifying adherence to the recommendations of the Brazilian Guidelines for Mechanical Ventilation by healthcare professionals. Method: methodological study, conducted between September and December 2019 in a public hospital with 87 patients. For content validation, the Content Validation Index was adopted; for criterion validity, Pearson's Correlation Coefficient; for internal consistency, Cronbach's alpha; and, for interobserver reliability, the Kappa Coefficient, and the Intraclass Correlation Coefficient. Results: the scale identified acceptable content validity and internal consistency. Pearson's correlation indicated a correlation between adherence score and saturation (r = 0.31; p≤0.005), the average score for observer A and B resulted, respectively, in 88.89(±5.23) and 88.86(±5.34), and the confidence interval was 0.96. Conclusion: the scale showed validity and reliability to verify adherence to the Brazilian Guidelines for Mechanical Ventilation by professionals.(AU)

Objetivo: construir y validar una escala para verificar la adherencia a las recomendaciones de las directrices brasileñas sobre ventilación mecánica por parte de los profesionales de la salud. Método: estudio metodológico, realizado entre septiembre y diciembre de 2019 en un hospital público con 87 pacientes. Se adoptó el Índice de Validación de Contenido para la validación de contenido, para la validez de criterio, el Coeficiente de Correlación de Pearson, para la consistencia interna, el alfa de Cronbach y, para la fiabilidad interobservador, el Coeficiente Kappa y el Coeficiente de Correlación Intraclase. Resultados: la escala presentó una validez de contenido y una consistencia interna aceptables. La correlación de Pearson indicó una correlación de la puntuación de adherencia con la saturación (r = 0,31; p≤0,005), la puntuación media para el observador A y B resultó de 88,89(±5,23) y 88,86(±5,34), respectivamente, y el intervalo de confianza fue de 0,96. Conclusión: la escala presentó validez y confiabilidad para verificar la adherencia a las Directrices Brasileñas de Ventilación Mecánica de los profesionales.(AU)

Current Strategies of Surface Modifications to Polyurethane Biomaterials for Vascular Grafts / 中国医学科学杂志(英文版)

As the number of patients suffering from cardiovascular diseases and peripheral vascular diseases rises, the constraints of autologous transplantation remain unavoidable. As a result, artificial vascular grafts must be developed. Adhesion of proteins, platelets and bacteria on implants can result in stenosis, thrombus formation, and postoperative infection, which can be fatal for an implantation. Polyurethane, as a commonly used biomaterial, has been modified in various ways to deal with the adhesions of proteins, platelets, and bacteria and to stimulate endothelium adhesion. In this review, we briefly summarize the mechanisms behind adhesions, overview the current strategies of surface modifications of polyurethane biomaterials used in vascular grafts, and highlight the challenges that need to be addressed in future studies, aiming to gain a more profound understanding of how to develop artificial polyurethane vascular grafts with an enhanced implantation success rate and reduced side effect.

Recent progress in application of nanovaccines for enhancing mucosal immune responses

Mucosal vaccines that stimulate both mucosal and systemic immune responses are desirable, as they could prevent the invading pathogens at their initial infection sites in a convenient and user-friendly way. Nanovaccines are receiving increasing attention for mucosal vaccination due to their merits in overcoming mucosal immune barriers and in enhancing immunogenicity of the encapsulated antigens. Herein, we summarized several nanovaccine strategies that have been reported for enhancing mucosal immune responses, including designing nanovaccines that have superior mucoadhesion and mucus penetration capacity, designing nanovaccines with better targeting efficiency to M cells or antigen-presenting cells, and co-delivering adjuvants by using nanovaccines. The reported applications of mucosal nanovaccines were also briefly discussed, including prevention of infectious diseases, and treatment of tumors and autoimmune diseases. Future research progresses in mucosal nanovaccines may promote the clinical translation and application of mucosal vaccines.

Junctional adhesion molecule-like protein as a novel target for kaempferol to ameliorate lung adenocarcinoma / 中西医结合学报

OBJECTIVE@#Although there have been improvements in targeted therapy and immunotherapy, the majority of lung adenocarcinoma (LUAD) patients still lack effective therapies. Consequently, it is urgent to screen for new diagnosis biomarkers and pharmacological targets. Junctional adhesion molecule-like protein (JAML) was considered to be an oncogenic protein and may be a novel therapeutic target in LUAD. Kaempferol is a natural flavonoid that exhibits antitumor activities in LUAD. However, the effect of kaempferol on JAML is still unknown.@*METHODS@#Small interfering RNA was used to knockdown JAML expression. The cell viability was determined using the cell counting kit-8 assay. The proliferation of LUAD cells was evaluated using the 5-ethynyl-2'-deoxyuridine incorporation assay. The migration and invasion of LUAD cells were evaluated by transwell assays. Molecular mechanisms were explored by Western blotting.@*RESULTS@#JAML knockdown suppressed proliferation, migration and invasion of LUAD cells, and JAML deficiency restrained epithelial-mesenchymal transition (EMT) via inactivating the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway. Using a PI3K activator (740Y-P), rescue experiments showed that phenotypes to JAML knockdown in LUAD cells were dependent on the PI3K/AKT/mTOR pathway. Kaempferol also inhibited proliferation, migration and invasion of A549 and H1299 cells and partially suppressed EMT through the PI3K/AKT/mTOR pathway. Knockdown of JAML ameliorated the inhibitory effect of kaempferol on LUAD cells. Kaempferol exerted anticancer effects by targeting JAML.@*CONCLUSION@#JAML is a novel target for kaempferol against LUAD cells. Please cite this article as: Wu Q, Wang YB, Che XW, Wang H, Wang W. Junctional adhesion molecule-like protein as a novel target for kaempferol to ameliorate lung adenocarcinoma. J Integr Med. 2023; 21(3): 268-276.

Research on Mechanisms of Chinese Medicines in Prevention and Treatment of Postoperative Adhesion / 中国结合医学杂志

Postoperative adhesion (PA) is currently one of the most unpleasant complications following surgical procedures. Researchers have developed several new strategies to alleviate the formation of PA to a great extent, but so far, no single measure or treatment can meet the expectations and requirements of clinical patients needing complete PA prevention. Chinese medicine (CM) has been widely used for thousands of years based on its remarkable efficacy and indispensable advantages CM treatments are gradually being accepted by modern medicine. Therefore, this review summarizes the formating process of PA and the efficacy and action mechanism of CM treatments, including their pharmacological effects, therapeutic mechanisms and advantages in PA prevention. We aim to improve the understanding of clinicians and researchers on CM prevention in the development of PA and promote the in-depth development and industrialization process of related drugs.

Trichostatin C attenuates TNFα-induced inflammation in endothelial cells by up-regulating Krüppel-like factor 2 / 药学学报

Krüppel-like transcription factor 2 (KLF2) plays a key regulatory role in endothelial inflammation, thrombosis, angiogenesis and macrophage inflammation and polarization, and up-regulation of KLF2 expression has the potential to prevent and treatment atherosclerosis. In this study, trichostatin C (TSC) was obtained from the secondary metabolites of rice fermentation of Streptomyces sp. CPCC 203909 as a KLF2 up-regulator by using a high throughput screening model based on a KLF2 promoter luciferase reporter assay. TSC significantly inhibited the adhesion of tumor necrosis factor-α (TNFα) induced monocytes (THP-1) to human umbilical vein endothelial cells (HUVECs). Western blot results showed that TSC decreased TNFα induced the protein expression increase of vascular cell adhesion molecule-1 (VCAM-1), and thereby inhibited endothelial inflammation. The results of histone deacetylase (HDAC) overexpression and molecular docking experiments showed that TSC upregulated the expression of KLF2 by inhibiting subtypes of HDAC 4/5/7. In conclusion, this study suggests that TSC up-regulates the expression of KLF2 through inhibiting HDAC 4/5/7 and thus inhibits TNFα induced endothelial inflammation, and it has the potential to prevent and treat atherosclerosis.

Perillyl alcohol modulates activation, permeability and integrity of human brain endothelial cells induced by Plasmodium falciparum

BACKGROUND Cerebral malaria (CM) is a severe immunovasculopathy caused for Plasmodium falciparum infection, which is characterised by the sequestration of parasitised red blood cells (pRBCs) in brain microvessels. Previous studies have shown that some terpenes, such as perillyl alcohol (POH), exhibit a marked efficacy in preventing cerebrovascular inflammation, breakdown of the brain-blood barrier (BBB) and brain leucocyte accumulation in experimental CM models. OBJECTIVE To analyse the effects of POH on the endothelium using human brain endothelial cell (HBEC) monolayers co-cultured with pRBCs. METHODOLOGY The loss of tight junction proteins (TJPs) and features of endothelial activation, such as ICAM-1 and VCAM-1 expression were evaluated by quantitative immunofluorescence. Microvesicle (MV) release by HBEC upon stimulation by P. falciparum was evaluated by flow cytometry. Finally, the capacity of POH to revert P. falciparum-induced HBEC monolayer permeability was examined by monitoring trans-endothelial electrical resistance (TEER). FINDINGS POH significantly prevented pRBCs-induced endothelial adhesion molecule (ICAM-1, VCAM-1) upregulation and MV release by HBEC, improved their trans-endothelial resistance, and restored their distribution of TJPs such as VE-cadherin, Occludin, and JAM-A. CONCLUSIONS POH is a potent monoterpene that is efficient in preventing P. falciparum-pRBCs-induced changes in HBEC, namely their activation, increased permeability and alterations of integrity, all parameters of relevance to CM pathogenesis.

Antígeno del factor von Willebrand (FVW: Ag) / von Willebrand factor antigen (VWF: Ag)

Utilidad clínica de la prueba El factor von Willebrand (FVW) es una glicoproteína compuesta por multímeros con pesos moleculares que pueden variar desde 500 KDa hasta 20.000 kDa, que se sintetiza en las células endoteliales y en los megacariocitos, y se almacena en los cuerpos de Weibel-Palade y en los gránulos alfa de las plaquetas [1]. El papel del FVW en la hemostasia primaria es mediar la adhesión de las plaquetas a los componentes de la matriz extracelular, a través de los complejos glucoproteicos plaquetarios GPIbα y αIIb3ß; en la hemostasia secundaria, se asocia con el factor VIII para prevenir su degradación y favorecer la generación de trombina para la formación del trombo final

Biomimetics and the restoration of the endodontically treated tooth / Biomimética e a restauração do dente tratado endodonticamente

Although much progress has been obtained in terms of the Endodontic treatment, the literature shows that true success can be only achieved with adequate coronal seal to avoid bacterial contamination, and protect the tooth structure from fracture. There are many options available to the clinician to restore the endodontically treated tooth; however, there is not much evidence available on what alternative is better than another. This review will critically present the current knowledge on restorative choices, including posts and endocrowns, showing advantages and disadvantages of different treatment forms. With this knowledge, we will also introduce the concept of biomimetics to endodontically treated teeth, and how the nature of their remaining tooth structure can benefit from this approach. This concept entails the use of mechanisms and biologically produced materials to restore a tooth in a way that would mimic its natural structure, with the purpose of achieving better long-term prognosis (AU)

Embora tenha se obtido progresso em relação ao tratamento endodôntico, a literatura mostra que o sucesso real só pode ser atingido com o selamento coronal adequado, para evitar-se a contaminação bacteriana e proteger-se a estrutura dental de fraturas. Há muitas opções disponíveis para o clínico para a restauração do dente tratado endodonticamente; entretanto, não há muita evidência disponível sobre qual alternativa é melhor que a outra. Esta revisão apresentará criticamente o conhecimento atual sobre opções restauradoras, incluindo retentores intraradiculares e endocrowns, mostrando vantagens e desvantagens das diferentes formas de tratamento. Com esse conhecimento, também introduziremos o conceito de biomimética, uma vez que dentes tratados endodonticamente, devido a natureza de sua estrutura dental remanescente, podem se beneficiar desta abordagem. Esse conceito envolve o uso de mecanismos e materiais produzidos biologicamente para restaurar um dente de forma a imitar a estrutura natural, com o objetivo de alcançar melhor prognóstico de longo-prazo.(AU)

Fatores associados a não adesão terapêutica em pessoas com hipertensão que procuraram assistência por emergência / Factors associated with therapeutic non-adherence among hypertensive individuals who seek emergency care / Factores asociados a la no adhesión a la terapia en personas hipertensas que buscan asistencia por emergencias

RESUMO: Objetivo: analisar fatores associados à não adesão terapêutica em pessoas com Hipertensão Arterial que procuraram serviços de pronto atendimento por emergência e/ou complicação hipertensiva. Método: estudo transversal realizado entre dezembro de 2019 a outubro de 2020, com 238 pessoas residentes em um município de médio porte do Sul do Brasil, mediante aplicação da Escala de Adesão Terapêutica de Oito Itens de Morisky. Na análise se utilizou Regressão Logística Múltipla. Resultados: 86 (36,1%) participantes foram considerados não aderentes. Foi observada maior chance de não adesão em pessoas com menos de 60 anos (Odds Ratio=2,04), que buscaram assistência nos serviços de pronto atendimento nos três anos em estudo (Odds Ratio=5,08) e que tinham vínculo com profissionais da Atenção Primária à Saúde (Odds Ratio=1,96). Conclusão: reconhecer os fatores associados com a não adesão à terapêutica possibilitará aos profissionais realizar intervenções educativas e assistir as pessoas com hipertensão de acordo com suas necessidades, prevenindo/postergando complicações.

ABSTRACT Objective: to analyze factors associated with therapeutic non-adherence among individuals with Arterial Hypertension who seek emergency care and/or assistance due to hypertensive complications. Method: this is a cross-sectional study conducted from December 2019 to October 2020 with 238 people living in a medium-sized municipality from southern Brazil using Morisky's 8-Item Medication Adherence Scale. Multiple Logistic Regression was used in the analysis. Results: a total of 86 (36.1%) participants were considered as non-adherent. A higher change of non-adherence was observed in people younger than 60 years of age (Odds Ratio=2.04), who sought emergency services in the three years under study (Odds Ratio=5.08), and who had a bond with Primary Health Care professionals (Odds Ratio=1.96). Conclusion: acknowledging the factors associated with non-adherence to the therapy will allow professionals to conduct educational interventions and assist people with hypertension according to their needs, thus preventing/postponing complications.

RESUMEN Objetivo: analizar factores asociados a la no adhesión a la terapia en personas con Hipertensión Arterial que asisten a servicios de urgencia por emergencias y/o complicaciones derivadas de la hipertensión. Método: estudio transversal realizado entre diciembre de 2019 y octubre de 2020 con 238 residentes en un municipio de mediano porte del sur de Brasil, utilizando la Escala de Adherencia Terapéutica de 8 ítems de Morisky. En el análisis se utilizó Regresión Logística Múltiple. Resultados: se consideró que 86 (36,1%) participantes no cumplían con la terapia. Se observó una mayor probabilidad de no adhesión en personas menores de 60 años (Odds Ratio=2,04), que buscaron asistencia en los servicios de urgencia en los tres años en estudio (Odds Ratio=5,08) y que tenían una relación con profesionales de Atención Primaria de la Salud (Odds Ratio=1,96). Conclusión: reconocer los factores asociados a la no adhesión a la terapia permitirá que los profesionales realicen intervenciones educativas y asistan a las personas con hipertensión arterial según sus necesidades, previniendo/posponiendo complicaciones.

Effect of multi-target protein tyrosine kinase inhibitor Ponatinib on proliferation,adhesion and migration ability of human liver cancer cell line SK-Hep-1 / 中国生物制品学杂志

@#Objective To investigate the effect of a multi-target protein tyrosine kinase inhibitor,Ponatinib,on proliferation,homogeneity adhesion and migration ability of human liver cancer cell line SK-Hep-1.Methods SK-Hep-1 cells were cultured routinely and added with 24 tyrosine kinase inhibitors such as Ponatinib respectively,and the effect of Ponatinib on the survival and proliferation of SK-Hep-1 cells was detected by MTT assay.SK-Hep-1 cells were cultured routinely until the fusion degree reached 90%,then added with 0.1,0.5 and 1.0 μmol/L Ponatinib respectively,and the control group(without Ponatinib) was set up.The effect of Ponatinib on adhesion ability of SK-Hep-1 cells was detected by cell slow aggregation assay and dissociation assay,while the effect on migration ability by scratch test,and the effect on E-cadherin protein expression in SK-Hep-1 cells by Western blot.Results All 24 tyrosine kinase inhibitors inhibited SK-Hep-1 cells,among which Ponatinib showed the strongest inhibitory effect with a IC_(50) of(0.288±0.044) μmol/L.Compared with the control group,the number of cell mass(t=16.143,44.002 and 44.853 respectively,each P <0.001) and N_(TC)/N_(TE) [ratio of single cell number(N) after digestion by trypsin containing EDTA(TE) and CaCl_2(TC)](t=4.276,10.625 and 27.571 respectively,each P <0.05) decreased significantly and E-cadherin protein expression increased significantly(t=-3.757,-4.561and-6.922 respectively,each P <0.05) in 0.1,0.5 and 1.0 μmol/L Ponatinib groups;Scratch migration rate significantly decreased in 0.5 and 1.0 μmol/L Ponatinib groups(t=6.272～16.733 respectively,each P <0.01),while there was no significant difference in 0.1 μmol/L Ponatinib group(t=0.473 and 0.872 respectively,each P> 0.05) after 24 h and 48 h of scratch.Conclusion Ponatinib inhibited proliferation and migration of SK-Hep-1 cells and promoted cell adhesion.