Maternal folic acid supplementation to prevent preeclampsia: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this systematic review was to examine the association between folic acid supplementation during pregnancy and the risk of preeclampsia. METHODS: Relevant studies were included by searching Embase, PubMed, Scope, Web of science, Cochrane Library databases. Studies were reviewed according to prespecified inclusion and exclusion criteria. Study characteristics were summarized, and study quality was assessed. Risk ratios (RR) and 95% confidence intervals (CI) were used as indicators of effect to assess the relationship between folic acid supplementation and risk of preeclampsia. RESULTS: The protocol of this study was prospectively registered with the PROSPERO (registration No. CRD42022380636). A total of nine studies were included, divided into three groups according to the type of study, containing a total of 107 051 and 105 222 women who were supplemented and not supplemented with folic acid during pregnancy. The results showed that folic acid supplementation during pregnancy could not be proven to reduce the risk of preeclampsia. CONCLUSION: The results of the study suggest that folic acid supplementation alone is not associated with a decreased risk of pre-eclampsia,but the inferences are somewhat limited by the low methodological quality of the included literature, and therefore higher quality studies are needed to prove this point.

Formulation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) modified orthodontic adhesive.

OBJECTIVES: The objective of this study was to synthesize arginine loaded mesoporous silica nanoparticles (Arg@MSNs), develop a novel orthodontic adhesive using Arg@MSNs as modifiers, and investigate the adhesive performance, antibacterial activity, and biocompatibility. METHODS: Arg@MSNs were synthesized by immobilizing arginine into MSNs and characterized using transmission electron microscope (TEM), dynamic light scattering (DLS), and Fourier Transform Infrared Spectrometer (FT-IR). Arg@MSNs were incorporated into Transbond XT adhesive with different mass fraction to form functional adhesives. The degree of conversion (DC), arginine release behavior, adhesive performance, antibacterial activity against Streptococcus mutans biofilm, and cytotoxicity were comprehensively evaluated. RESULTS: TEM, DLS, and FT-IR characterizations confirmed the successful preparation of Arg@MSNs. The incorporation of Arg@MSNs did not significantly affect DC and exhibited clinically acceptable bonding strength. Compared to the commercial control, the Arg@MSNs modified adhesives greatly suppressed the metabolic activity and polysaccharide production while increased the biofilm pH values. The cell counting kit (CCK)-8 test indicated no cytotoxicity. CONCLUSIONS: The novel orthodontic adhesive containing Arg@MSNs exhibited significantly enhanced antibacterial activities and inhibitory effects on acid production compared to the commercial adhesive without compromising their bonding strength or biocompatibility. CLINICAL SIGNIFICANCE: The novel orthodontic adhesive containing Arg@MSNs exhibits potential clinical benefits in preventing demineralization of enamel surfaces around or beneath orthodontic brackets due to its enhanced antibacterial activities and acid-producing inhibitory effects.

Preparation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) to improve the mechanical and antibacterial properties of denture base resin.

STATEMENT OF PROBLEM: Whether the incorporation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) into denture base resin can improve the mechanical and antibacterial properties is unclear. PURPOSE: The purpose of this in vitro study was to synthesis Arg@MSNs and explore how Arg@MSNs incorporation affects the mechanical and antibacterial properties of denture base resin. MATERIAL AND METHODS: Arg@MSNs were synthesized via a sol-gel process and characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS), and X-ray diffraction (XRD). The prepared Arg@MSNs at different weight ratio concentrations were added into denture base resin as the experimental group, and unmodified denture base resin was the control. The fracture surface and arginine release behavior of each specimen were detected using scanning electron microscopy (SEM) and ultra-high-performance liquid chromatography-tandem mass spectrometer (UHPLC-HESI-MS/MS), respectively. Three-point bend tests were applied using a universal testing machine for evaluation of the mechanical properties of each group (n=5). Antibacterial efficiency (n=3) was evaluated by both quantitative and qualitative analysis using Streptococcus mutans. The cytotoxic effect of the Arg@MSN-modified denture base resin was investigated using a cell counting kit (CCK)-8 test. Data were subjected to 1-way analysis of variance followed by the post hoc Tukey honestly significant difference test (ɑ=.05). RESULTS: The prepared Arg@MSNs had good monodispersity and spherical morphology. Arg@MSN concentration at 0.5 wt%, 1 wt%, and 2.5 wt% resulted in enhanced mechanical properties, while those at 5 wt% were adversely impacted. Biofilm pH values increased with the incorporation of Arg@MSNs, and the antibacterial performance was improved. The CCK-8 test revealed that all formulations were not cytotoxic. CONCLUSIONS: The addition of Arg@MSNs into denture base resin can enhance its mechanical properties and improve its antibacterial performance without any apparent cytotoxic effect.

[Evaluation methods of clinical efficacy of traditional Chinese medicine].

Clinical efficacy is the basis for the development of traditional Chinese medicine(TCM), and the evaluation of clinical efficacy of TCM has always been the focus of attention. The technical and methodological difficulties in the evaluation process often restrict the generation of high-level evidence. Therefore, methodological research should be deepened and innovative practice should be carried out to study the application of scientific research methods in the evaluation of the advantages of TCM. After more than ten years of development, the clinical efficacy evaluation of TCM, on the basis of the initially classic placebo randomized controlled trials, has successively carried out a series of meaningful attempts and explorations in N-of-1 trials, cohort studies, case-control studies, cross-sectional studies, real world studies, narrative medicine studies, systematic evaluation, and other aspects, laying the foundation for the transformation of TCM from "experience" to "evidence". This paper focused on the clinical efficacy evaluation of TCM, summarized the main connotation and development status of efficacy evaluation indicators, standards, and methods, and put forward corresponding countermeasures and suggestions for the problems of indicator selection, standard formulation, and methodology optimization in the research process. It is clear that scientific and objective evaluation of the efficacy of TCM is an urgent problem to be solved at present.

[Problems and thoughts in clinical safety evaluation of traditional Chinese medicine].

Amid the modernization and internationalization of traditional Chinese medicine(TCM), the safety of TCM has attracted much attention. At the moment, the government, scientific research teams, and pharmaceutical enterprises have made great efforts to explore methods and techniques for clinical safety evaluation of TCM. Although considerable achievements have been made, there are still many problems, such as the non-standard terms of adverse reactions of TCM, unclear evaluation indicators, unreasonable judgment methods, lack of evaluation models, out-of-date evaluation standards, and unsound reporting systems. Therefore, it is urgent to further deepen the research mode and method of clinical safety evaluation of TCM. Based on the current national requirements for the life-cycle management of drugs, this study focused on the problems in the five dimensions of clinical safety evaluation of TCM, including normative terms, evaluation modes, judgment methods, evaluation standards, and reporting systems, and proposed suggestions on the development of a life-cycle clinical safety evaluation method that conformed to the characteristics of TCM, hoping to provide a reference for future research.

Antifungal efficiency and cytocompatibility of polymethyl methacrylate modified with zinc dimethacrylate.

Objectives: Considering the high incidence rates of denture stomatitis, research that providing dental biomaterials with antifungal property are essential for clinical dentistry. The objectives of the present study were to investigate the effect of zinc dimethacrylate (ZDMA) modification on the antifungal and cytotoxic properties, as well as the variance in surface characteristics and other physicochemical properties of polymethyl methacrylate (PMMA) denture base resin. Methods: PMMA with various mass fraction of ZDMA (1 wt%, 2.5 wt% and 5 wt%) were prepared for experimental groups, and unmodified PMMA for the control. Fourier-transform infrared spectroscopy (FTIR) was applied for characterization. Thermogravimetric analysis, atomic force microscopy and water contact angle were performed to investigate the thermal stability and surface characteristics (n=5). Antifungal capacities and cytocompatibility were evaluated with Candida albicans (C. albicans) and human oral fibroblasts (HGFs), respectively. Colony-forming unit counting, crystal violet assay, live/dead biofilm staining and scanning electron microscopy observation were performed to assess antifungal effects, and the detection of intracellular reactive oxygen species production was applied to explore the possible antimicrobial mechanism. Finally, the cytotoxicity of ZDMA modified PMMA resin was evaluated by the 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and live/dead double staining. Results: The FTIR analyses confirmed some variation in chemical bonding and physical blend of the composites. Incorporation of ZDMA significantly enhanced the thermal stability and hydrophilicity compared with unmodified PMMA (p < 0.05). The surface roughness increased with the addition of ZDMA while remained below the suggested threshold (≤ 0.2 µm). The antifungal activity significantly improved with ZDMA incorporation, and cytocompatibility assays indicated no obvious cytotoxicity on HGFs. Conclusions: In the present study, the ZDMA mass fraction up to 5 wt% in PMMA performed better thermal stability, and an increase in surface roughness and hydrophilicity without enhancing microbial adhesion. Moreover, the ZDMA modified PMMA showed effective antifungal activity without inducing any cellular side effects.

Efficacy and safety of zhibitai in the treatment of hyperlipidemia: A systematic review and meta-analysis.

Objective: To evaluate the efficacy and safety of Zhibitai (ZBT) in the treatment of patients with hyperlipidemia (HLP). Methods: A search of 8 electronic databases was conducted to find randomized controlled trials (RCTs), to evaluate the efficacy and safety of ZBT for the treatment of HLP. The risk of bias in randomized controlled trials was assessed by using the Cochrane Collaboration Risk of Bias tool for randomized controlled trials 2.0 (RoB 2.0). The primary outcomes were the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). The total effective rate served as the secondary outcome. The incidence of adverse events was considered the safety outcome. Review Manager 5.4 was used to conduct meta-analyses. Data were pooled by random-effects or fixed-effects model to obtain the mean difference (MD), risk ratio (RR), odds ratio (OR), and 95% confidence interval (CI). Results: There were 28 eligible RCTs with a total of 2,952 participants. Overall, we verified that ZBT plus conventional therapy (CT) was superior to CT for the treatment of HLP [TC: MD = -0.50, 95% CI (-0.80, -0.19); TG: MD = -0.38, 95% CI (-0.49, -0.27); LDL-C: MD = -0.50, 95% CI (-0.69, -0.31); HDL-C: MD = 0.17, 95% CI (0.11, 0.24); total effective rate: OR = 4.26, 95% CI (2.28, 7.95)]. There were no significant differences in the primary outcomes between ZBT alone vs. CT (p > 0.05). For safety, the ZBT group (with CT or alone) outperformed the CT group [ZBT alone: RR = 0.51, 95% CI (0.32, 0.81); ZBT plus CT: RR = 0.51, 95% CI (0.30, 0.89)]. For each outcome, the subgroups and the sensitivity analysis matched the overall results. Conclusion: ZBT may be safe and beneficial to HLP patients, especially for serum lipid management. ZBT can be used along with CT for the treatment of HLP. However, it is necessary to conduct more rigorous RCTs to confirm these findings. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022316251].

Mechanical and antibacterial properties of polymethyl methacrylate modified with zinc dimethacrylate.

STATEMENT OF PROBLEM: Polymethyl methacrylate (PMMA) has been widely used for denture base resin. However, concerns associated with PMMA, such as poor mechanical strength, high roughness, and porosity promoting microbial adhesion have been voiced; appropriate modification of PMMA denture base resin may improve its clinical application. PURPOSE: The purpose of this in vitro study was to investigate the effect of zinc dimethacrylate (ZDMA) modification on the mechanical and antibacterial properties of PMMA. MATERIAL AND METHODS: ZDMA at different mass fractions was mixed into PMMA as the experimental group, and unmodified PMMA was the control group. X-ray diffraction (XRD), scanning electron microscopy-energy dispersive spectrometry (SEM-EDS), and the degree of conversion (DC%) were applied for characterization. Mechanical properties were measured with the 3-point bend test (n=10). The Streptococcus mutans biofilm model was used to investigate the antibacterial property by using colony-forming unit counts, metabolic activity, live/dead staining, quantitative real-time PCR (qRT-PCR), and SEM (n=5). The cell counting kit (CCK)-8 test was used to evaluate cytotoxicity. Data were subjected to analysis of variance and the post hoc Tukey honestly significant difference test (α=.05). RESULTS: SEM-EDS and XRD analysis revealed successful ZDMA incorporation into the PMMA matrix. DC% increased with the mass fraction of ZDMA, and no significant differences in DC% values were found among each tested group (P=.554). ZDMA mass fraction at 1 wt%, 2.5 wt%, and 5 wt% enhanced its mechanical properties, but those at 7.5 wt% and 10 wt% were reduced. The results of antibacterial experiments showed that ZDMA-modified PMMA displayed antibiofilm capabilities. Quantitative real-time PCR indicated that the expression levels of tested genes were significantly suppressed and that CCK-8 test indicated no cytotoxicity. CONCLUSIONS: ZDMA-modified PMMA exhibited antibacterial properties without its mechanical properties being affected. ZDMA is a potential metal crosslinking monomer for the modification of PMMA denture base resin.

Fibroblast activation protein-alpha knockdown suppresses prostate cancer cell invasion and proliferation.

BACKGROUND: Prostate cancer is one of the most common malignant tumors of the male genitourinary system. Fibroblast activation protein alpha (FAP-α) overexpression has been shown to occur in a wide range of tumors. However, the specific mechanism of FAP-α in the development of prostate cancer has not been reported. METHODS: In this study, real-time quantitative PCR (qRT-PCR) was used to detect the relative expression of FAP-α mRNA in prostate cancer cell lines (PC-3, LNCaP, and DU145) and human normal prostate epithelial cell line RWPE-1. Small interfering RNA (siRNA) targeting FAP-α and vectors expressing exogenous FAP-α were transfected to prostate cancer cells (LNCaP and DU145) to investigate the function of FAP-α. BALB/c nude mice were injected with DU145 cells which were transfected with NC-siRNA, FAP-α-siRNA-1, or FAP-α-siRNA-2. RESULTS: Compared to adjacent normal tissues, FAP-α protein and mRNA levels in prostate cancer tissues increased significantly (P<0.05). Compared to patients with high FAP-α mRNA levels, patients with low FAP-α mRNA levels had a significantly higher survival rate (χ²=5.050, log-rank P=0.025). Overexpression of FAP-α in LNCaP cells markedly inhibited cell apoptosis, and promoted cell invasion and proliferation. In contrast, knockdown of FAP-α expression in DU145 cells can significantly reduce invasion, proliferation, and promote apoptosis in prostate cancer. Immunofluorescence assay further indicated that down-regulation of FAP-α could suppress the nuclear translocation of ß-catenin. An in vivo study found that compared with the NC-siRNA group, the tumor weight and tumor volume in the FAP-α-siRNA-1 and FAP-α-siRNA-2 groups were significantly decreased. CONCLUSIONS: In conclusion, down-regulation of FAP-α can inhibit the invasion and proliferation of prostate cancer. Our study provides a theoretical basis for the targeted treatment of prostate cancer.