Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke.

Objectives: Dysphagia is a common complication in stroke patients, widely affecting recovery and quality of life after stroke. The objective of this systematic review is to identify the gaps that between evidence and practice by critically assessing the quality of clinical practice guidelines (CPGs) for management of dysphagia in stroke. Methods: We systematically searched academic databases and guideline repositories between January 1, 2014, and August 1, 2023. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used by two authors to independently assess CPG quality. Results: In a total of 14 CPGs included, we identified that three CPGs obtained a final evaluation of "high quality," nine CPGs achieved "moderate quality" and two CPGs received "low quality." The domain of "scope and purpose" achieved the highest mean score (91.1%) and the highest median (IQR) of 91.7% (86.1, 94.4%), while the domain of "applicability" received the lowest mean score (55.8%) and the lowest median (IQR) of 55.4% (43.2, 75.5%). Conclusion: The CPG development group should pay more attention to improving the methodological quality according to the AGREE II instrument, especially in the domain of "applicability" and "stakeholder involvement;" and each item should be refined as much as possible.

Distribution and characteristics of microplastics in an urban river: The response to urban waste management.

The rivers have been proven to be potential sources and the major transport pathways of microplastic (MP) in natural aquatic eco-systems, yet there is an absence of understanding the provenances and distribution dynamics of MP in fluvial water body of urban regions. The present investigation aimed to characterize the distribution and accumulation of MPs in both surface water and riverine bed sediments in a typical urban river (Nanming River, southwest China), during the dry and wet seasons of 2021. MP were detected throughout the entire sample set, with average surface water abundances of 750 ± 53 n/m3 and 693.3 ± 40 n/m3 in dry and wet seasons, respectively, and 2250 ± 496.7 n/kg (dw) in surface sediments. Furthermore, the composition of 25 polymer types MPs were analyzed. The sediment of the Nanming River is a sink for MPs, recording their long-term accumulation. Multivariate statistical analysis-based results indicated that urban littering and agricultural input were the major contributors of non-point MP in the Nanming River, while the discharged effluent was another factor influencing the distribution of MPs in urban fluvial system. The average abundance of MPs was negatively correlated with purchase power parity (PPP), demonstrating that the poorly waste management results in a higher abundance of MPs in municipal river systems. The present study systematically characterized the distribution of MPs in medium-sized urban rivers systems in Southwest China. These findings can inform policy and management decisions to reduce MPs pollution in urban rivers and protect aquatic ecosystems.

Study on the application effect of the family doctor contract service mode of 'basic package+personalised package' in elderly hypertension management in Chengdu, China: a retrospective observational study.

OBJECTIVES: We conducted this study to assess the application effect of the family doctor contract service mode of 'basic package+personalised package' in the management of hypertension patients. DESIGN: Observational study. SETTING: The study was conducted at a community health centre in Southwest China. Data were collected from 1 January 2018 to 31 December 2020. PARTICIPANTS: From 1 January 2018 to 31 December 2020, hypertensive patients (age ≥65 years) who participated in the contract services of family doctors at a community health service centre in Chengdu, Southwest China, were selected as the study subjects. MAIN OUTCOME MEASURES: The primary outcomes included mean blood pressure (systolic, diastolic) and the rate of blood pressure control, secondary outcomes included the level of cardiovascular disease risk and self-management ability. Assessments of baseline and 6 months after signing up were conducted on all outcomes. The major statistical analysis methods included two independent sample t-tests, paired t-tests, Pearson's χ2 test, McNemar's test, two independent sample Mann-Whitney U tests and paired sample marginal homogeneity tests. RESULTS: Of the 10 970 patients screened for eligibility, 968 (8.8%) were separated into an observation group (receiving 'basic package+personalised package (hypertension)' service) (n=403) and a control group (receiving 'basic package' service) (n=565) according to the type of service package they received. In comparison to the control group, the observation group had lower mean systolic blood pressure (p=0.023), higher blood pressure control rate (p<0.001), lower cardiovascular disease risk level (p<0.001) and higher self-management ability level (p<0.001) at 6 months after signing up. The mean diastolic blood pressure of the two groups was not significantly different (p=0.735). CONCLUSIONS: The family doctor contract service model of 'basic package+personalised package (hypertension)' has a good application effect in the management of elderly hypertension, which can improve the average blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk and self-management ability of the elderly with hypertension.

Rapid urbanization affects microplastic communities in lake sediments: A case study of Lake Aha in southwest China.

Effective management of pollutants in urban environments is crucial for achieving sustainable cities. Microplastics, as an emerging pollutant widely present in contemporary environments, have received widespread attention in recent years. However, limited studies have reported the impact of rapid urbanization on regional microplastics. In this study, the abundance and composition of microplastic communities in the sediments of Lake Aha were analyzed using a "microplastic community" and slicing the sediments at 5 cm intervals. Results showed that microplastic abundance of sediments in Lake Aha was relatively high (up to 1700 items/kg) and decreased with increasing depth, with the highest abundance found in the surface layer (0-5 cm, 1090 ± 474 items/kg). Hierarchical cluster analysis (HCA), principal component analysis (PCA), and analysis of similarities (ANOSIM) revealed that the different sediment layers could be classified into high and low urbanization level groups based on the composition of microplastic communities. Linear discriminant analysis effect size (LEfSe) indicated that agricultural input was the main source of microplastic pollution during low urbanization levels, characterized by low abundance, large particle size, and high fiber proportion, while urban activities dominated during high urbanization levels, with high abundance, small particle size, high proportion of Polyethylene terephthalate (PET), fragments, and granules, and colorful microplastics. This study clarifies the impact of urbanization on the abundance and composition of microplastics in lake sediments, which has implications for more effective management and control of microplastic pollution in regions undergoing rapid urbanization.

Distribution and removal mechanism of microplastics in urban wastewater plants systems via different processes.

Microplastic pollution threatens water systems worldwide. As one of the most important parts of city wastewater treatment, wastewater treatment plants are not only microplastics interception barriers but also emission sources. Water samples were collected from each sewage treatment plant stage and sludge from the sludge dewatering room. Microplastics were extracted using wet peroxide oxidation and flotation, and the abundance, size, shape, and polymer type of microplastics were detected. Basis on the results, the influence of each process on the removal rate and characteristics of microplastics under the same influent source was analysed. The influent microplastic concentration in this study was 32.5 ± 1.0 n/L, which rapidly decreased after treatment. The removal rates of the sequencing batch reactor activated sludge, cyclic activated sludge, and anaerobic anoxic oxic technologies were 73.0%, 75.6%, and 83.9%, respectively. Most microplastics were transported to the sludge, and the concentration of microplastics in dehydrated sludge was 27.2 ± 3.1 n/g. Microplastics removal occurred primarily during the primary and secondary stages. Disposal processes, settling time, and process design affected wastewater treatment plant microplastic removal rates at each stage. Significant differences in microplastic characteristics were observed at each stage, with the most abundant being fragment shaped, particle sizes of 30-100 µm, and black in colour. Sixteen polymer types were identified using a Raman spectrometer. The predominant polymers are polypropylene, polyethylene, and polyethylene terephthalate. This study demonstrates that optimising the process design of existing wastewater treatment plants is crucial for the prevention and control of microplastic pollution. It is suggested that the process settings of contemporary wastewater treatment plants should be studied in depth to develop a scientific foundation for avoiding and managing microplastic pollution in urban areas.

Buffer zone-based trace elements indicating the impact of human activities on karst urban groundwater.

The tanglesome allocation of landscape types at various spatial dimensions is an important component influencing the quality of groundwater environment in karst cities. Trace elements can be used as indicators of the extent of impact on groundwater which is an effective means of tracing groundwater contamination. In this study, we studied the influence of landscape patterns on trace elements in groundwater of typical karst cities in Southwest China (Guiyang City) on a multi-spatial scale by using multivariate statistical analysis. According to the sampling points, buffer zone scales with different radii (500 m, 1000 m, 1500 m, and 4000 m) were established to quantify the land use model. There are suburban and urban differences in trace element content. The city center has higher levels of trace elements compared to suburban areas, especially Li, Ni, Tl, Cu, Sr, Co, As, and Mn. In addition, the outcomes of the multiple linear regression had shown that the size effect of the association from landscape pattern to trace elements varies with different indicators and parameters. The results of redundancy analysis showed an overall change in trace elements was better interpreted by the landscape pattern of the 1500 m-scale buffer. At the same time, at the 1500 m scale, Ni, Tl, Cu, Co, As, Cr, Sr, Li, and Mn were positively correlated with the urban landscape index (4LPI, 4LSI), influenced by urban anthropogenic activities, while Cd, Zn, and Pb were positively correlated with the cropland landscape index (1AI, 1LPI), influenced by agricultural activities. This study indicates that trace elements are a reliable indicator for tracing groundwater contamination. The buffer zone can reflect the extent of urban impacts on groundwater and provide a new and effective analytical tool for groundwater management.

Coupled controls of the infiltration of rivers, urban activities and carbonate on trace elements in a karst groundwater system from Guiyang, Southwest China.

Hydrogeochemical processes of trace elements (TEs) are of considerable significance to river water and groundwater resource assessment and utilization in the karst region. Therefore, seven TEs were analyzed to investigate their contents, spatial variations, sources, and controlling factors in Guiyang, a typical karst urban area in southwest China. The results showed that the average content of TEs in river water (e.g., As = 1.44 ± 0.47 µg/L andCo = 0.15 ± 0.06 µg/L) was higher than that of groundwater (e.g., As = 0.51 ± 0.42 µg/L andCo = 0.09 ± 0.05 µg/L). The types of groundwater samples were dominated by Ca/Mg-HCO3 and Ca/Mg-Cl types, while those of the river water samples were Ca-Cl and Ca/Mg-Cl types. Principal component analysis (PCA) and correlation analysis (CA) analyses indicated that As and Mn in the groundwater of the study area were related to river infiltration. The end-member analysis further revealed that river infiltration (As = 0.86-1.81 µg/L, Cl/SO42- = 0.62-0.89) and urban activities (As = 0.21-0.32 µg/L, Cl/SO42- = 0.51-0.89) were two main controlling factors of TEs (e.g., As, Co, and Mn) in the study area. In addition, the ion ratios in river and groundwater samples indicated that the weathering of carbonates was also an important control on the hydrogeochemistry of TEs (e.g., Fe and Mn) in Guiyang waters. This study showed that the trace element (TE) contents of groundwater in the Guiyang area were greatly associated with urban input and river recharge, and provided a new perspective for understanding the geochemical behavior of TEs in urban surface and groundwater bodies, which will help the protection of groundwater in the karst areas of southwest China.

Anthropogenic rare earth elements in urban lakes: Their spatial distributions and tracing application.

Anthropogenic activities associated with various new technologies are increasingly disrupting the geochemical cycles of rare earth elements (REEs). For example, samarium (Sm) and gadolinium (Gd) have emerged as microcontaminants in the natural waters of developed areas. Surface water samples of 13 urban lakes were collected in Wuhan, the largest city in central China, with a population of over 11 million. The aim of this study was to examine to what extent REE anomalies occur and the relationship between the concentration of anthropogenic REEs in lakes and the surrounding environment. In this study, based on land-use type and point of interest (POIs) data, buffer extraction, density estimation and Spearman correlation analysis were first proposed to identify different sources of anthropogenic REEs, which mainly included hospitals, factories, population, urban land and cropland. The PAAS-normalized REE patterns indicate that all lake samples display pronounced positive Sm and Gd anomalies, ranging from 5.92 to 19.88 and 1.73 to 14.97, respectively. Spearman correlation analysis showed that hospital density was positively correlated with anthropogenic Gd concentration, and a positive relationship between proportion of cropland and the concentration of anthropogenic Sm. By utilizing Gdanth, Smanth, and the conventional ion ratio (NO3-/Cl-), a three-dimensional tracer system was established, and the system accurately obtained a characterization of the impact of WWTPs, hospitals, factories and agriculture on the lakes. Moreover, the results from this hydrochemical method were consistent with the analysis of geographic information systems, which indicated that this anthropogenic contaminant as a tracer was reliable for analysing the source of urban water pollution.

Trace Metal Concentrations in Surface Water Along the Yangtze River in Chongqing, China: Urban Discharge Impacts.

Urban rivers are suffering from a significant anthropogenic impact. In this study, eight trace metals were investigated in surface water along the Yangtze River in Chongqing, China. The decreasing trend of trace metals was observed in water as Sr > Li > Mo > As > Cu > Ni > Cr > Co. Multivariate statistical analysis identified two source types that accounted for 77.17% of the total variance. As, Co, Mo, and Sr were mainly originated from geological sources, while Cr, Cu, and Ni were influenced by anthropogenic activities. Moreover, the average contents of Cr, Cu, and Ni exhibited a significant increase close to the city compared to the sites that are far away from the city, which was identified by various urban rivers. This study suggested that Cr, Cu, and Ni could be regarded as anthropophile elements, which could be a promising indicator for tracing the urban activities.

Protective Effect of Selenium-Enriched Green Tea on Carbon Tetrachloride-Induced Liver Fibrosis.

The major pathogenic feature of liver fibrosis is that oxidative stress motivation of hepatic stellate cells (HSCs) alters the balance between the synthesis and degradation of extracellular matrix (ECM) and HSCs into proliferative myofibroblasts. Green tea and selenium (Se) can protect the liver from damage; however, the precise mechanism of green tea and the action of Se in green tea on hepatic fibrosis remain unclear. Several studies have demonstrated the profibrogenic role of 5-hydroxytryptamine (5-HT) and 5-hydroxytryptamine receptor (5-HTR) 2A/2B in the liver. The current study aimed to investigate the protective effects and possible mechanisms of selenium-enriched green tea on carbon tetrachloride (CCl4)-induced liver fibrosis in male C57BL/6 J mice. After a 4-week intervention with tea solution, histological analysis of the liver showed that green tea interventions alleviated hepatic fibrosis, which was supported by the changes in collagen type I, collagen type III, and α-smooth muscle actin in the liver. Tea interventions significantly inhibited the CCl4-provoked increase of duodenal 5-HT and tryptophan hydroxylase and hepatic 5-HT and 5-HTR2A/2B levels. All of them were lower in the selenium-enriched green tea group than in regular green tea group. Se-enriched green tea had a more pronounced improvement in liver ECM deposition and scar formation and peripheral 5-HT signals than regular green tea. Thus, green tea, especially those enriched with selenium, can improve liver fibrosis through intestinal 5-HT-hepatic 5-HTR signaling.

Distribution, source, water quality and health risk assessment of dissolved heavy metals in major rivers in Wuhan, China.

Heavy metals are released into the water system through various natural processes and anthropogenic activities, thus indirectly or directly endangering human health. The distribution, source, water quality and health risk assessment of dissolved heavy metals (V, Mn, Fe, Co, Ni, Zn, As, Mo, Sb) in major rivers in Wuhan were analyzed by correlation analysis (CA), principal component analysis (PCA), heavy metal pollution index (HPI), hazard index (HI) and carcinogenic risk (CR). The results showed that the spatial variability of heavy metal contents was pronounced. PCA and CA results indicated that natural sources controlled Mn, Fe, Co, Ni and Mo, and industrial emissions were the dominant factor for V, Zn and Sb, while As was mainly from the mixed input of urban and agricultural activities. According to the heavy metal pollution index (HPI, ranging from 23.74 to 184.0) analysis, it should be noted that As and Sb contribute most of the HPI values. The health risk assessment using HI and CR showed that V and Sb might have a potential non-carcinogenic risk and As might have a potential carcinogenic risk to adults and children in the study area (CR value exceeded target risk 10-4). At the same time, it was worth noting that As might have a potential non-carcinogenic risk for children around QLR (HI value exceeded the threshold value 1). The secular variation of As and Sb should be monitor in high-risk areas. The results of this study can provide important data for improving water resources management efficiency and heavy metal pollution prevention in Wuhan.

Hsa_circ_0026628 promotes the development of colorectal cancer by targeting SP1 to activate the Wnt/ß-catenin pathway.

Circular RNAs (circRNAs) have been reported to play crucial roles in the progression of various cancers, including colorectal cancer (CRC). SP1 (Sp1 transcription factor) is a well-recognized oncogene in CRC and is deemed to trigger the Wnt/ß-catenin pathway. The present study was designed to investigate the role of circRNAs which shared the same pre-mRNA with SP1 in CRC cells. We identified that hsa_circ_0026628 (circ_0026628), a circular RNA that originated from SP1 pre-mRNA, was upregulated in CRC cells. Sanger sequencing and agarose gel electrophoresis verified the circular characteristic of circ_0026628. Functional assays including CCK-8, colony formation, transwell, immunofluorescence staining, and sphere formation assay revealed the function of circ_0026628. RNA pull-down and mass spectrometry disclosed the proteins interacting with circ_0026628. Mechanistic assays including RIP, RNA pull-down, CoIP, ChIP, and luciferase reporter assays demonstrated the interplays between molecules. The results depicted that circ_0026628 functioned as a contributor to CRC cell proliferation, migration, EMT, and stemness. Mechanistically, circ_0026628 served as the endogenous sponge of miR-346 and FUS to elevate SP1 expression at the post-transcriptional level, thus strengthening the interaction between SP1 and ß-catenin to activate the Wnt/ß-catenin pathway. In turn, the downstream gene of Wnt/ß-catenin signaling, SOX2 (SRY-box transcription factor 2), transcriptionally activated SP1 and therefore boosted circ_0026628 level. On the whole, SOX2-induced circ_0026628 sponged miR-346 and recruited FUS protein to augment SP1, triggering the downstream Wnt/ß-catenin pathway to facilitate CRC progression.

Interleukin-8 as a candidate for thymoma identification and recurrence surveillance.

Thymoma is the most common tumor of the anterior mediastinum. Routine imaging methods such as computed tomography or magnetic resonance imaging often lead to misdiagnosis between thymoma and other thymic abnormalities. Therefore, urgently needed is to develop a new diagnostic strategy. Here we identify interleukin-8 (IL-8) as a biomarker for auxiliary diagnosis of thymoma. We find that IL-8 levels in naïve T cells are markedly elevated in patients with thymoma compared to those with other thymic tumors. IL-8 levels in naive T cells are significantly decreased after surgical resection in thymoma patients, and rise again when thymoma recurs. A receiver operating characteristic curve analysis shows that IL-8 evaluation performs well in thymoma identification, with high specificities and sensitivities. We also observe significant clinical relevance between IL-8 levels in naïve T cells and clinicopathological features. In conclusion, our study suggests that IL-8 is a biomarker for thymoma identification and recurrence surveillance.

Discovery and anticancer evaluation of a formononetin derivative against gastric cancer SGC7901 cells.

Background Gastric cancer (GC) is the second most common cause of cancer-related death worldwide. Novel anticancer drugs against gastric cancer are urgently needed. Methods Compound 10 was designed and synthesized via a molecular hybridization strategy based on the natural product formononetin. It was evaluated for their antiproliferative activity against three gastric cancer cell lines (SGC7901, MKN45 and MGC803). Results Derivative 10 displayed potently antiproliferative activity with an IC50 value of 1.07 µM against SGC7901 cells. Derivative 10 could inhibit the growth and migration against gastric cancer SGC7901 cells through the Wnt/ß-Catenin and AKT/mTOR pathways. From the in vivo expremints, it could effectively inhibited SGC7901 xenograft tumor growth in vivo without significant loss of the body weight. Conclusion Derivative 10 is an novel antitumor agent with potential for further clinical applications to treat gastric cancer. Graphical abstract.

Silencing TRIP13 inhibits cell growth and metastasis of hepatocellular carcinoma by activating of TGF-ß1/smad3.

BACKGROUND: TRIP13 is highly expressed in several cancers and is closely connected with cancer progression. However, its roles on the growth and metastasis of hepatocellular carcinoma (HCC), and the underlying mechanism are still unclear. METHODS: Combining bioinformatics with previous studies, the correlation between TRIP13 and HCC was predicted. TRIP13 expressions from 52 HCC patients and several cell lines were determined. The effects of silencing TRIP13 on cell viability, apoptosis, migration and invasion were respectively detected using CCK-8, flow cytometry and Transwell. qRT-PCR and western blot were performed to reveal associated mechanism. A HCC model was established in BALB/c-nu mice by transplanting HepG2 cells. TRIP13 protein expression and apoptosis in mice tissues were accordingly detected by Immunohistochemistry and TUNEL. RESULTS: High expression of TRIP13 in HCC affected the survival rate and it was enriched in RNA degradation and fatty acid metabolism according to bioinformatics and prediction from previous literature. Increased expression of TRIP13 in HCC patient tissues was associated with the progression of HCC. Silencing TRIP13 inhibited cell viability, migration and invasion, and induced cell apoptosis. TRIP13 knockdown also suppressed the formation of tumor in vivo. Meanwhile, silencing TRIP13 decreased the expressions of Ki67 and MMP-2 and increased the expressions of TIMP-2, active-caspase-3 and TGF-ß1/smad3 signaling- related genes. CONCLUSIONS: Silencing TRIP13 acts as a tumor suppresser of HCC to repress cell growth and metastasis in vitro and in vivo, and such a phenomenon possibly involved activation of TGF-ß1/smad3 signaling.

Comparison of HLA-A, -B and -DRB1 Loci Polymorphism between Kidney Transplants of Uremia Patients and Healthy Individuals in Central China.

Chronic kidney disease is becoming a global public health problem, which will usually cause uremia at the end stage of chronic kidney failure. So far, kidney transplant is the most effective and proper therapy for uremia, however, the short supply of matched donor kidney has been a persistent bottleneck for transplantation. HLA matching of HLA-A, -B and -DRB1 loci is very important for the allocation of kidney transplants. In this study, we investigated genotypes of HLA-A, -B and -DRB1 loci based on 1,464 uremia patients and 10,000 unrelated healthy individuals in Henan province of China, and compared the frequency distribution of these HLA alleles and corresponding haplotypes between patient and healthy groups. We detected 23 HLA-A, 49 HLA-B and 17 HLA-DRB1 alleles in total. The predominant alleles of HLA-A, -B and -DRB1 loci in patients are the same as those in healthy group. The seven most frequent alleles account for about 87%, 50%, and 77% at HLA-A, -B and -DRB1 loci, respectively. The haplotypes (combinations of HLA-A, -B, and -DRB1) with significantly different frequency between patients and controls mostly account for less than 1%. Overall, this suggests that HLA matching is not a potential difficulty for kidney transplant of uremia patients. However, three of the top seven frequent HLA-DRB1 alleles have a significantly different distribution in patients and controls, while only one alleles for HLA-B and zero for HLA-A loci. These HLA-DRB1 alleles may be closely associated with uremia. This study sheds new lights on the composition and difference of HLA genotypes in uremia patients and healthy populations in Central China that can serve as a guide to HLA matching for kidney transplants and a resource for HLA typing-related studies.

Reduced ATG-F dosage for induction in pediatric renal transplantation: a single-center experience.

Rabbit antithymocyte globulin (ATG-F) is an extensively used induction agent. To our knowledge, no study to date has assessed reduced ATG-F dosage in children undergoing renal transplantation. This was a retrospective analysis of pediatric renal recipients in the Department of Kidney Transplantation, The First Affiliated Hospital of Zhengzhou University, from May 2007 to February 2013. Thirty-nine children underwent renal transplantation including 25 living related and 14 cardiac deceased donor transplantation. Each recipient received ATG-F 1.5 mg/kg/d once daily for 4 days. Of the 39 recipients, five (12.8%) showed delayed graft function, including one of 25 recipients (4%) of living donor and four of 14 recipients (28.6%) of deceased donor transplantation (p < 0.05). Six of the 39 recipients (15.4%) showed acute rejection on renal biopsy. Follow-up in these children ranged from 6 to 87 months. The one-, three-, and five-yr recipients and grafts survival rates postoperation were each 94.9% and 97.3%, 97.3%, and 94.6%, respectively. The incidence of postoperative infection was 35.9% (14/39), and did not differ significantly in the living related and deceased donor groups (p > 0.05). Low-dose ATG-F can be safely used as an immune induction agent in pediatric renal transplantation.