The Association of Conventional Therapy Associated with Somatosensory Interactive Game Enhances the Effects of Early Pulmonary Rehabilitation for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.

Objective: This study aimed to evaluate the effect of somatosensory interactive games in combination with pulmonary rehabilitation programs (PRPs) on exercise tolerance, balance function, pulmonary function, inflammatory markers, and healthcare utilization in individuals with acute exacerbation of chronic obstructive pulmonary disease over 12 months. Design: In a randomized controlled trial, 80 patients were divided into two groups. The control group participated in a lasted 30 minutes daily program composed of postural training for 10 minutes, limb movement for 10 minutes, and breathing exercises for 10 minutes based on regular oxygen therapy and medication. The experimental group received a once-daily, 20-minute somatosensory interactive game session based on the control group. Patients began treatment within 48 hours after admission and lasted for 6 weeks. Results: The time × group interactions on 6-minute walk distance (6MWD) and Brief Balance Evaluation Systems Test (Brief-BESTest) between the two groups were significant (P < 0.001). At the postintervention and each time point of follow-up, the 6-minute walk distance (6MWD) and Brief-BESTest of the intervention group were significantly higher than those of the control group (P < 0.05). The effects of time factor on forced expiratory volume in one second and forced vital capacity were statistically significant (P < 0.05). The 6MWD and Brief-BESTest of the intervention group peaked 3 months after the intervention and were higher than the control group within 12 months. C-reactive protein and procalcitonin were similar between the groups before and after intervention (P > 0.05). The readmission rates and mean length of time spent in the hospital were comparable between the groups at 12 months (P > 0.05). Conclusions: The addition of somatosensory interactive games based on a PRP was safe and feasible, and this benefit persisted for 12 months, peaked at 3 months after the intervention, and then gradually decreased.

Reliability, Validity, Modification and Expansion of the Chinese Version of the Disease-Specific Anxiety Questionnaire for Chronic Obstructive Pulmonary Disease.

Purpose: To translate a disease-specific anxiety questionnaire on chronic obstructive pulmonary disease (COPD) and test its reliability and validity in China. Patients and Methods: The German version of the revised COPD Anxiety Questionnaire (CAF-R) was initially validated using step-by-step translation, back-translation, and cross-cultural adaptation. The reliability and validity of the Chinese version of the CAF-R (CAF-R-CN) were tested among 448 patients with COPD (mean age =71.42±9.33 years, 17.2% female) from four medical institutions in Suzhou, Jiangsu Province, using convenience sampling, from April 2022 to June 2023. Results: The CAF-R-CN included six dimensions with a total of 25 items. The item-level content validity index was 0.860-1.000; the scale-level content validity index was 0.920. The structural validity χ2/df was 2.326, the root mean square error of approximation was 0.077, the comparative fit index was 0.924, and the Tucker-Lewis index was 0.912. The six-dimensional internal consistency index Cronbach's α coefficient was 0.696-0.910, and the test-retest reliability was 0.949. An optimal cut-off score of 50.5 was selected with a sensitivity of 0.786 and specificity of 0.870. Conclusion: The CAF-R-CN had satisfactory reliability and validity and can be used to identify and assess anxiety in COPD patients with a Chinese cultural background.

Development and validation of a model for the early prediction of progression from essential thrombocythemia to post-essential thrombocythemia myelofibrosis: a multicentre retrospective study.

Background: Essential thrombocythemia (ET), a myeloproliferative neoplasm (MPN), has a substantial risk of evolving into post-essential thrombocythemia myelofibrosis (post-ET MF). This study aims to establish a prediction nomogram for early prediction of post-ET MF in ET patients. Methods: The training cohort comprised 558 patients from 8 haematology centres between January 1, 2010, and May 1, 2023, while the external validation cohort consisted of 165 patients from 6 additional haematology centres between January 1, 2010, and May 1, 2023. Univariable and multivariable Cox regression analysis was performed to identified independent risk factors and establish a nomogram to predict the post-ET MF free survival. Both bias-corrected area under the curve (AUC), calibration curves and concordance index (C-index) were employed to assess the predictive accuracy of the nomogram. Findings: Multivariate Cox regression demonstrated that elevated red blood cell distribution width (RDW), elevated levels of lactate dehydrogenase (LDH) and the level of haemoglobin (Hb), a history of smoking and the presence of splenomegaly were independent risk factors for post-ET MF. The C-index displayed of the training and validation cohorts were 0.877 and 0.853. The 5 years, 10 years AUC values in training and external validation cohorts were 0.948, 0.769 and 0.978, 0.804 respectively. Bias-corrected curve is close to the ideal curve and revealed a strong consistency between actual observation and prediction. Interpretation: We developed a nomogram capable of predicting the post-ET MF free survival probability at 5 years and 10 years in ET patients. This tool helps doctors identify patients who need close monitoring and appropriate counselling. Funding: This research was funded by the Key R&D Program of Zhejiang (No. 2022C03137); the Public Technology Application Research Program of Zhejiang, China (No. LGF21H080003); and the Zhejiang Medical Association Clinical Medical Research special fund project (No. 2022ZYC-D09).

Impaired Skeletal Muscle in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD) Compared with Non-COPD Patients.

Purpose: This study was designed to investigate the differences in skeletal-muscle atrophy between patients with stable chronic obstructive pulmonary disease (COPD) and healthy controls; associated factors were also considered. The study comprised selected residents of communities near the First Affiliated Hospital of Soochow University in Suzhou City, East China. Patients and Methods: Included in this study were 123 COPD patients and 60 controls. All patients completed spirometry as well as examinations to determine their functional exercise capacity, body composition, and handgrip strength (HGS). Results: COPD patients had less fat-free mass (FFM), a lower FFM index (FFMI), and a lower 6-min walking distance (6MWD) compared with controls (P = 0.007, P = 0.020, and P < 0.001, respectively) (FFMI: 17.59 ± 1.83 vs 18.34 ± 1.64). The HGS of these patients was also lower compared with that of controls (32.88 ± 7.84 vs 35.48 ± 7.42), and HGS tended toward statistical significance (P = 0.064, respectively). In multivariate analysis, age (ß = -0.107, P < 0.001), gender (ß = 0.212, P < 0.001), body mass index (BMI) (ß = 0.462, P < 0.001), FEV1% (ß = 0.108, P = 0.009), and calf circumference (CC) (ß = 0.457, P < 0.001) were significantly associated with FFMI. Conclusion: Impaired skeletal muscle mass was more common in COPD patients than in controls. Multiple regression analysis showed that CC may be used to detect the degree of impairment, particularly by health-care providers working outside of the hospital.

Association Between Anthropometric Indices and Skeletal-Muscle Atrophy in Chinese Patients with Stable Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.

Purpose: Anthropometric indices are simple indicators of patient nutritional status. However, the association between these indices and skeletal-muscle atrophy in patients with stable chronic obstructive pulmonary disease (COPD) has not been fully investigated. In this study, we evaluated this association. Patients and Methods: We recruited 123 outpatients with stable COPD from a general hospital in China from 2020 to 2021. We recorded their demographic characteristics, including age, sex, course of illness, dyspnea score, body mass index (BMI), force expiratory volume in 1 second (FEV1), forced vital capacity (FVC), smoking status, and severity grading. In addition, patients' anthropometric indices, including fat-free mass index (FFMI) and appendicular skeletal-muscle mass index (ASMI), were measured using a body composition analyzer, and measurements were taken of the triceps skinfold (TSF), midarm circumference (MAC), and calf circumference (CC). We drew and analyzed a receiver operating characteristic (ROC) curve to identify the best intercept point value for the assessment of skeletal-muscle atrophy. Results: The TSF, MAC, CC, FFMI, and ASMI of COPD patients were 1.08 ± 0.44 cm, 26.39 ± 2.92 cm, 34.5 ± 3.06 cm, 17.49 ± 1.86 kg/m2, and 8.17 ± 0.90 kg/m2, respectively. These anthropometric indices had a significant positive correlation with skeletal-muscle mass (correlation values, 0.481-0.820). CC was strongly correlated with both FFMI and ASMI. The ROC curve showed an area-under-the-curve (AUC) value of 0.873-0.959. Conclusion: Anthropometric indices were correlated with skeletal-muscle mass. CC showed the best diagnostic value in COPD patients, suggesting its effectiveness as a simple method for assessing skeletal-muscle atrophy and identifying patients with a noticeable reduction in muscle mass. Such patients require early, multidisciplinary intervention.

Application of multi-active center organic quinone molecular functionalized graphene in fully pseudocapacitive asymmetric supercapacitors.

5, 7, 12, 14-pentacenetetrone (PT), polycyclic quinone derivatives, are rich in carbonyl, which were investigated as a novel organic electrode material for supercapacitors. PT with aπconjugated system, is a flat molecule, generating strongπ-πinteractions between molecules. PT molecules were uniformly fixed on conductive reduced graphene oxide (rGO) throughπ-πinteraction by one-step solvothermal method, forming a three-dimensional cross-linked PT@rGO hydrogel. This composite structure was conducive to reducing the charge transfer resistance and promoting the Faraday reaction of electrode, which achieved the superposition of electric double-layer capacitance and pseudocapacitance. Appropriate organic molecular loading can effectively improve electrochemical performance. The optimal PT@rGO electrode material displayed the specific capacitance of 433.2 F g-1at 5 mV s-1with an excellent rate capability in 1 mol l-1H2SO4electrolyte. Finally, the fully pseudocapacitive asymmetric supercapacitor has been assembled by using PT@rGO as positive electrode and benz[a]anthracene-7,12-quinone (BAQ) modified rGO(BAQ/rGO)as negative electrode, which exhibited the good energy storage performance in a cell voltage of 1.8 V.

Analysis of risk factors for early urinary tract infection after kidney transplantation.

BACKGROUND: Urinary tract infection (UTI) is the most common kind of infection in the early stage after kidney transplantation. Although many studies have investigated the risk factors for UTI following kidney transplantation, few studies have focused on the risk factors for UTI in the early stage after transplantation. METHODS: The early-stage data of patients who underwent kidney transplantation between January 2018 and December 2019 in a first-class tertiary hospital in Suzhou, China, were retrospectively analyzed. The general and UTI information of the recipients was subjected to univariate analysis. Variables with statistical significance in the univariate analysis were included in a multivariate logistic regression model. RESULTS: A total of 129 recipients were recruited, among whom 62 patients had a UTI in the early stage after kidney transplantation (48.1%), and the median (interquartile range) of onset time was 5 (4, 10) days after the surgery. A total of 324 strains of UTI pathogens were detected in the 62 recipients after kidney transplantation, 279 of which were gram-negative bacilli (86.1%). Multivariate logistic regression analysis showed that female sex and delayed graft function (DGF) were independent risk factors for early-stage UTI, with odds ratios of 0.095 and 3.753, respectively. CONCLUSIONS: The incidence of early UTI after kidney transplantation is high. Females and DGF patients are more prone to UTIs. Comprehensive prevention and treatment measures should be taken as early as possible against the risk factors to reduce the incidence of UTI.

The use of a homemade rate adjustment card in patients with continuous bladder irrigation after transurethral resection of the prostate.

BACKGROUND: In China, the incidence of benign prostatic hyperplasia (BPH) is rising with the average lifespan of men. Transurethral resection of the prostate (TURP) is recognized as the gold standard for surgical treatment of BPH. Continuous bladder irrigation (CBI) is often required after operation. The irrigation rate is often manually adjusted based on the color of the drainage fluid, but it is difficult to know how much to adjust it based on color. To better adjust the irrigation rate and reduce related complications, we developed and evaluated a post-TURP CBI rate adjustment card. METHODS: A total of 103 BPH patients who underwent post-TURP CBI at our hospital between April and July 2020 were enrolled in this study and were assigned to the control group (n=49) or the experimental group (n=54) according to the different hospital areas. In the control group, the CBI rate was adjusted based on the clinical evaluation of the color of the drainage fluid; in the experimental group, the CBI rate was adjusted based on the color of drainage fluid evaluated with our homemade post-TURP CBI rate adjustment card. RESULTS: The incidence of bladder spasm, the incidence of clot-related catheter blockage, the volume of irrigation solution used, and the irrigation time were significantly lower or shorter in the experimental group than in the control group. The patient satisfaction score was significantly higher in the experimental group (P<0.05). CONCLUSIONS: For BPH patients receiving post-TURP CBI, the homemade post-TURP CBI rate adjustment card can provide objective data for clinical care, reduce postoperative complications, and improve patient satisfaction. Therefore, it should be more widely used in clinical practice.

Factors associated with appendicular skeletal muscle mass among male Chinese patients with stable chronic obstructive pulmonary disease: A hospital-based cross-sectional study.

Limbs muscle wasting is a common disorder in patients with chronic obstructive pulmonary disease (COPD) that limits daily activities and exercise intolerance, especially in males. The present study aimed to estimate the prevalence of appendicular skeletal muscle mass (ASM) in male patients with stable COPD. In addition, factors associated with parameters of ASM were also investigated.We recruited 116 male patients with stable COPD from the outpatient clinic between September 2016 and December 2017. For each patient, we obtained demographic characteristics and measured post-bronchodilator forced expiratory volume in 1 second, symptoms, exacerbations history, and ASM. ASM was defined as the sum of the muscle masses of the 4 limbs.Appendicular skeletal muscle mass index (ASMI) in male patients with stable COPD was 8.2 ±â€Š0.9 kg/m, and the prevalence of low skeletal muscle mass was 7.8% (9 of 116 patients). Multiple linear-regression analysis showed that body mass index, occupation, fat-free mass index, and the modified medical research council scale were significantly correlated with ASMI. Compared with nonexercise group, lower limb muscle mass and ASM were significantly improved in physical exercise group.Underweight, retirement, fat-free mass depletion, and severe dyspnea are all risk factors for ASM in male patients with stable COPD. Our findings also justify the importance of exercise training in improving ASM.

Composite Membranes of Recombinant Silkworm Antimicrobial Peptide and Poly (L-lactic Acid) (PLLA) for biomedical application.

Antimicrobial peptides, produced by innate immune system of hosts in response to invading pathogens, are capable of fighting against a spectrum of bacteria, viruses, fungi, parasites and cancer cells. Here, a recombinant silkworm AMP Bmattacin2 from heterologous expression is studied, indicating a broad spectrum of antibacterial activity and showing selective killing ability towards skin and colon cancer cells over their normal cell counterparts. For the purpose of biomedical application, the electrospinning fabrication technique is employed to load Bmattacin2 into PLLA nanofibrous membrane. In addition to a good compatibility with the normal cells, Bmattacin2 loaded nanofibrous membranes demonstrate instant antibacterial effects and sustained anticancer effects. The cancer cell and bacteria targeting dynamics of recombinant Bmattacin2 are investigated. With these characteristics, PLLA/Bmattacin2 composite membranes have a great potential for developing novel biomedical applications such as cancer therapies and wound healing treatments.

[Apoptosis of acute myeloid leukemia HL-60 cells induced by CDK inhibitor SNS-032 and its molecular mechanisms].

OBJECTIVE: To investigate the effects of cycle-dependent kinase (CDK) inhibitor SNS-032 on apoptosis in human acute myeloid leukemia (AML) HL-60 cells and its molecular mechanisms. METHODS: Cultured AML HL-60 cells were treated with various concentrations of SNS-032. Cell apoptosis was determined with flow cytometry;cell viability was measured by MTT assay; the profiles of microRNA expression of HL-60 cells were analyzed by microRNA microarray;the protein expressions of JAK2/STAT3 pathway were detected by Western blotting. RESULTS: Apoptosis of AML HL-60 cells was induced by SNS-032; the rate of apoptosis was (5.9±1.7)%, (12.1±3.1)% and (59.4±3.6)% when HL-60 cells were treated with 0,100 and 200 nmol/L SNS-032. MicroRNA microarray analysis revealed that the levels of miR-30a, miR-183, miR-20b, miR-26b, miR-20a, miR-589, miR-107, miR-181a, miR-106a, miR-17 and miR-378c were down-regulated by SNS-032,whereas the levels of miR-320a and miR-H7* were up-regulated. Western blotting showed that SNS-032 strongly inhibited phosphorylation of STAT3 and protein expression of JAK2,C-MYC and MCL-1. CONCLUSION: CDK inhibitor SNS-032 can induce apoptosis of AML HL-60 cells, which is associated with the inhibition of MCL-1,C-MYC and JAK2/STAT3, and down-regulation of miR-17-92 family.

Nano polypeptide particles reinforced polymer composite fibers.

Because of the intensified competition of land resources for growing food and natural textile fibers, there is an urgent need to reuse and recycle the consumed/wasted natural fibers as regenerated green materials. Although polypeptide was extracted from wool by alkaline hydrolysis, the size of the polypeptide fragments could be reduced to nanoscale. The wool polypeptide particles were fragile and could be crushed down to nano size again and dispersed evenly among polymer matrix under melt extrusion condition. The nano polypeptide particles could reinforce antiultraviolet capability, moisture regain, and mechanical properties of the polymer-polypeptide composite fibers.

Antitumor effect and mechanism of an ellagic acid derivative on the HepG2 human hepatocellular carcinoma cell line.

In the present study, to identify the effective components of Chinese traditional herbs, Euphorbia hylonoma Hand.-Mazz. (Euphorbiaceae), a folk herb that has been used among the Qinling mountain area for hundreds of years, was investigated. 3,3'-Di-O-methyl ellagic acid-4'-O-ß-d-xylopyranoside (JNE2), an ellagic acid derivative, was isolated from the acetone extract of the herb and its antitumor activity against human hepatoma HepG2 cells was detected in vitro. The results showed that JNE2 inhibited the proliferation of HepG2 cells in a dose- and time-dependent manner and blocked the cell cycle at the G1/S phase. A high dosage of JNE2 induced apoptosis of the tumor cells, but no significant differences were identified between the treatment groups. The invasiveness of HepG2 cells was also inhibited by JNE2. The mechanism of the antitumor effect of JNE2 at the molecular level was presumed to be due to the upregulation of the protein expression of Bax and caspase-3, and the downregulation of the protein expression of Bcl-2 and CCND1. The results suggested that JNE2 is a potential antitumor agent that merits further investigation.

Toxicity study of isolated polypeptide from wool hydrolysate.

The cytotoxicity of wool polypeptide has been evaluated by both cell and animal models. Wool was dissolved in sodium hydroxide solution, the pH value of the solution was adjusted to 5.55 and the precipitate was harvested as wool polypeptide. The spray-dried polypeptide was collected as powders and characterized by SEM, FTIR and TG-DSC. The cell culturing results showed that wool polypeptide had no obvious negative effect on cell viability in vitro. Both acute oral toxicity and subacute 30-day oral toxicology studies showed that wool polypeptide had no influence on body weight, feed consumption, blood chemistry, and hematology at any dose levels. There were no treatment related findings on gross or detailed necroscopy, organ weights, organ/body weight ratios and histology. Our study indicated the absence of toxicity in wool polypeptide and supported its safe use as a food ingredient or drug carrier.

[Analysis of petroleum fraction from flower, stem and leaf of Aconitum taipeicum by GC-MS].

OBJECTIVE: To analyze the chemical constituents of petroleum fraction of Aconitum taipeicum. METHODS: The methanol extract of Aconitum taipeicum were extracted by petroleum and then analyzed by GC-MS. The compounds were quantitatively determined by normalization method. RESULTS: Twenty eight compounds were separated and identified. Most of them were alkane, fat acids and their esters and alkenes. The Nonacosane covered 13.057% of the total peaks, while 19-methyl-18,21-Hexatriacontanediether 8.180%, Ethylen eglycol monooctadecy ether 7.851%, 3,7,11,15-Tetramethyl-2-hexadecen-1-ol 7.805%, Metahyl Palmitate 6.676% and so on. CONCLUSION: This is the first report of constituents from the flower, stem and leaf of Aconitum taipeicum. The results will provide foundation for further exploitation and use of Aconitum taipeicum.

Synthesis and characterization of wool keratin/hydroxyapatite nanocomposite.

Taking the inspiration from the biomineral, the wool keratin was selected to modulate the assembly of nanosized hydroxyapatite (HA) crystals via a coprecipitation method. A series of keratin/HA nanocomposite with different ratios were synthesized by adjusting the concentrations of keratin solutions and calcium phosphate and their final components were detected by thermogravimetric analysis (TGA). The transmission electron microscopy (TEM) and X-ray diffraction (XRD) confirmed that keratin in the composite decreased the crystallinity of HA. Fourier transform infrared (FTIR) and X-ray photoelectron spectroscopy (XPS) were used to examine the chemical and surface structure of the composites. In vitro biocompatibility results revealed that cells showed better viability on keratin/HA composites which have a ratio of organics and inorganics similar to that of natural bones.

Two novel naphthalene glucosides and an anthraquinone isolated from Rumex dentatus and their antiproliferation activities in four cell lines.

An ethyl acetate extract of the roots of Rumex dentatus L. was investigated. Three compounds were identified by their spectroscopic data as chrysophanol (1), 6-methyl-7-acetyl-1, 8-dihydroxy-3-methoxy naphthalene-1-O-ß-D(L)-glucoside (2) and 6-methyl-7-acetyl-1, 8-dihydroxy naphthalene-1-O-ß-D(L)-glucoside (3) were found in the plant for the first time. Compounds 2 and 3 are novel compounds. Their antiproliferation activities were tested by the MTT assay in four cell lines (breast cancer MCF-7, gastric cancer 7901, melanoma A375 and oophoroma SKOV-3).

Density functional theory study of the platinum-catalyzed cyclopropanation reaction with olefin.

A computational study of the platinum-catalyzed cyclopropanation reaction with olefin is presented. The model system is formed by an ethylene molecule and the active catalytic species, which forms from a CH2 fragment and the Cl2Pt(PH3)2 complex. The results show that the active catalytic species is not a metal-carbene of the type (PH3)2Cl2Pt=CH2 but two carbenoid complexes which can exist in almost two degenerate forms, namely (PH3)2Pt(CH2Cl)Cl (carbenoid A) and (PH3)Pt(CH2PH3)Cl2 (carbenoid B). The reaction proceeds through three pathways: methylene transfer, carbometalation for carbenoid A, and the reaction of a monophosphinic species for carbenoids (A and B). The most favored reaction channel is methylene transfer pathway for (PH3)Pt(CH2PH3)Cl2 (carbenoid B) species with a barrier of 31.32 kcal/mol in gas phase. The effects of dichloromethane, THF, and benzene solvent are investigated with PCM method. For carbenoid A, both methylene transfer and carbometalation pathway barriers to reaction become remarkably lower with the increasing polarity of solvent (from 43.25 and 52.50 kcal/mol for no solvent to 25.36 and 38.53 kcal/mol in the presence of the dichloromethane). In contrast, the reaction barriers for carbenoid B via the methylene transfer path hoist 6.30 kcal/mol, whereas the barriers do not change significantly for the reaction path of a monophosphinic species for carbenoids (A and B).