The oral bacterial microbiota facilitates the stratification for ulcerative colitis patients with oral ulcers.

BACKGROUND: Clinically, a large part of inflammatory bowel disease (IBD) patients is complicated by oral lesions. Although previous studies proved oral microbial dysbiosis in IBD patients, the bacterial community in the gastrointestinal (GI) tract of those IBD patients combined with oral ulcers has not been profiled yet. METHODS: In this study, we enrolled four groups of subjects, including healthy controls (CON), oral ulcer patients (OU), and ulcerative colitis patients with (UC_OU) and without (UC) oral ulcers. Bio-samples from three GI niches containing salivary, buccal, and fecal samples, were collected for 16S rRNA V3-V4 region sequencing. Bacterial abundance and related bio-functions were compared, and data showed that the fecal microbiota was more potent than salivary and buccal microbes in shaping the host immune system. ~ 22 UC and 10 UC_OU 5-aminosalicylate (5-ASA) routine treated patients were followed-up for six months; according to their treatment response (a decrease in the endoscopic Mayo score), they were further sub-grouped as responding and non-responding patients. RESULTS: We found those UC patients complicated with oral ulcers presented weaker treatment response, and three oral bacterial genera, i.e., Fusobacterium, Oribacterium, and Campylobacter, might be connected with treatment responding. Additionally, the salivary microbiome could be an indicator of treatment responding in 5-ASA routine treatment rather than buccal or fecal ones. CONCLUSIONS: The fecal microbiota had a strong effect on the host's immune indices, while the oral bacterial microbiota could help stratification for ulcerative colitis patients with oral ulcers. Additionally, the oral microbiota had the potential role in reflecting the treatment response of UC patients. Three oral bacteria genera (Fusobacterium, Oribacterium, and Campylobacter) might be involved in UC patients with oral ulcers lacking treatment responses, and monitoring oral microbiota may be meaningful in assessing the therapeutic response in UC patients.

Nonalcoholic fatty liver disease aggravates acute pancreatitis through bacterial translocation and cholesterol metabolic dysregulation in the liver and pancreas in mice.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for severe acute pancreatitis (AP). The underlying mechanism remains unclear. We sought to determine how bacterial translocation and cholesterol metabolism in the liver and pancreas affect the severity of AP in NAFLD mice. METHODS: C57BL/6N mice were fed on a high-fat diet (HFD) to generate the NAFLD model, and mice in the control group were provided with a normal diet (ND). After being anesthetized with ketamine/xylazine, mice got a retrograde infusion of taurocholic acid sodium into the pancreatic duct to induce AP, and sham operation (SO) was used as control. Serum amylase and Schmidt's pathological score system were used to evaluate AP severity. Bacterial loads, total cholesterol level, and cholesterol metabolic-associated molecules [low-density lipoprotein receptor (LDLR) and ATP-binding cassette transporter A1 (ABCA1)] were analyzed in the liver and pancreas. RESULTS: Compared with the ND-AP group, mice in the HFD-AP group had severer pancreatitis, manifested with higher serum amylase levels and higher AP pathologic scores, especially the inflammation and hemorrhage scores. Compared with the HFD-SO group and ND-AP group, bacterial loads in the liver and pancreas were significantly higher in the HFD-AP group. Mice in the HFD-AP group showed a decreased LDLR expression and an increased ABCA1 expression in the pancreas, although there was no significant difference in pancreas total cholesterol between the HFD-AP group and the ND-AP group. CONCLUSIONS: NAFLD aggravates AP via increasing bacterial translocation in the liver and pancreas and affecting pancreas cholesterol metabolism in mice.

A Deep Learning Algorithm for Detecting Acute Pericarditis by Electrocardiogram.

(1) Background: Acute pericarditis is often confused with ST-segment elevation myocardial infarction (STEMI) among patients presenting with acute chest pain in the emergency department (ED). Since a deep learning model (DLM) has been validated to accurately identify STEMI cases via 12-lead electrocardiogram (ECG), this study aimed to develop another DLM for the detection of acute pericarditis in the ED. (2) Methods: This study included 128 ECGs from patients with acute pericarditis and 66,633 ECGs from patients visiting the ED between 1 January 2010 and 31 December 2020. The ECGs were randomly allocated based on patients to the training, tuning, and validation sets, at a 3:1:1 ratio. We used raw ECG signals to train a pericarditis-DLM and used traditional ECG features to train a machine learning model. A human-machine competition was conducted using a subset of the validation set, and the performance of the Philips automatic algorithm was also compared. STEMI cases in the validation set were extracted to analyze the DLM ability of differential diagnosis between acute pericarditis and STEMI using ECG. We also followed the hospitalization events in non-pericarditis cases to explore the meaning of false-positive predictions. (3) Results: The pericarditis-DLM exceeded the performance of all participating human experts and algorithms based on traditional ECG features in the human-machine competition. In the validation set, the pericarditis-DLM could detect acute pericarditis with an area under the receiver operating characteristic curve (AUC) of 0.954, a sensitivity of 78.9%, and a specificity of 97.7%. However, our pericarditis-DLM also misinterpreted 10.2% of STEMI ECGs as pericarditis cases. Therefore, we generated an integrating strategy combining pericarditis-DLM and a previously developed STEMI-DLM, which provided a sensitivity of 73.7% and specificity of 99.4%, to identify acute pericarditis in patients with chest pains. Compared to the true-negative cases, patients with false-positive results using this strategy were associated with higher risk of hospitalization within 3 days due to cardiac disorders (hazard ratio (HR): 8.09; 95% confidence interval (CI): 3.99 to 16.39). (4) Conclusions: The AI-enhanced algorithm may be a powerful tool to assist clinicians in the early detection of acute pericarditis and differentiate it from STEMI using 12-lead ECGs.

Efficacy and safety of lubiprostone for the treatment of functional constipation in Chinese adult patients: A multicenter, randomized, double-blind, placebo-controlled trial.

OBJECTIVES: Functional constipation is a gastrointestinal disorder prevalent around the world. Lubiprostone is the first locally acting type-2 chloride channel activator to be used for treating constipation. This study aimed to evaluate the efficacy and safety of lubiprostone in Chinese adults with functional constipation. METHODS: This was a multicenter, randomized, double-blind, placebo-controlled study. Patients with functional constipation were randomized to receive either lubiprostone (24 mcg twice daily) or placebo for 4 weeks. The primary end-point was the frequency of spontaneous bowel movements (SBMs) during the first week of treatment. The secondary end-points included the median time of the first SBM, SBM frequency at weeks 2, 3 and 4, weekly response rate of SBMs, the stool consistency score and average number of complete spontaneous bowel movements (CSBMs) per week. RESULTS: In total, 259 patients were randomized, with 130 in the lubiprostone group and 129 in the placebo group. SBM frequency was higher in the lubiprostone group (4.88 ± 4.09/wk) than that in the placebo group (3.22 ± 2.01/wk) at week 1 (P < 0.0001). SBM frequency was also higher in the lubiprostone group at weeks 2, 3 and 4. The average number of CSBMs and the stool consistency score in the lubiprostone group were significantly higher than that in the placebo group at each week. No drug-related serious adverse events (AEs) occurred. The most commonly reported AE was nausea. CONCLUSION: Lubiprostone was superior to placebo in treating Chinese patients with functional constipation, together with good safety profile.

Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population.

BACKGROUND: It is unknown whether the reflux symptom index (RSI) can replace pH monitoring as a diagnostic tool for laryngopharyngeal reflux (LPR) in Chinese people. The relationships between reflux parameters and LPR symptoms also require further research. METHODS: A total of 216 Chinese patients underwent laryngopharyngeal pH monitoring and filled out an RSI questionnaire. Laryngopharyngeal pH monitoring indicated a diagnosis of LPR for patients with 7 or more episodes of reflux or a reflex area index (RAI) of 6.3 or more. The RSI questionnaire indicated a diagnosis of LPR for patients with RSI scores of 14 or higher. RESULTS: Of the 216 patients, 85 were diagnosed with LPR as assessed by the RSI, and 72 were diagnosed with LPR through laryngopharyngeal pH monitoring. The Cohen's kappa coefficient comparing LPR diagnosis consistency between RSI score and laryngopharyngeal pH monitoring was 0.133 (P=0.007). This indicated the two diagnostic methods were consistent to a low degree; the total consistency rate was only 59.7% (129/216). The sensitivity of the RSI was 48.6% (35/72), and its specificity was 82.5% (94/114). For convenience, we named the nine symptom groups in the RSI sequentially as P1-P9. P1, P2, P3, P5, P6, and P7 were all correlated with at least one reflux parameter (P<0.05), but P4, P8, and P9 were not correlated with any reflux parameters (P>0.05). A total of 72 patients were diagnosed using pH monitoring, the gold standard for LPR diagnosis. The most common symptoms of LPR were found to be P9, P3, P8, P7, and P2 in these patients. The symptoms that most seriously affected patients were P9, P8, P3, P7, and P2. CONCLUSIONS: The consistency in diagnosis of LPR between the RSI and laryngopharyngeal pH monitoring was poor, meaning the RSI is not a suitable LPR initial screening tool and cannot replace pH monitoring. Additionally, reflux symptoms P4, P8, and P9 were not correlated with any reflux parameters. The most prevalent LPR symptom was P9, followed by P3, P8, P7, and P2. The most severe symptom was also P9, followed by P8, P3, P7, and P2.

[Influence on orbicularis oculi muscle in the patients with facial neuritis treated with the penetra-ting needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62)].

OBJECTIVE: To explore the therapeutic effect on incomplete eyelid in the patients with facial neuritis treated with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62). METHODS: A total of 64 patients with facial neuritis, in compliance with the inclusion criteria, were randomized into a treatment group and a control group, with 32 cases in each. In the treatment group, the penetrating needling was applied to BL2 and EX-HN4 on the affected side, combined with the perpendicular needling at bilateral BL62. Besides, on the affected side, the penetrating needling was applied from Yangbai (GB14) toward four directions, named Shangxing (GV23), Touwei (ST8), Cuanzu (BL2) and Sizukong (TE23), the mutual penetrating needling was adopted between Dicang (ST4) and Jiache (ST6). Between Yingxiang (LI20) and Xiaguan (ST7), a row-arranged needling technique was applied. All of the needles were retained for 10 to 30 min in each treatment. The treatment was given once daily and the treatment for 10 days was as 1 course. A total of 2 courses of treatment were required. In the control group, prednisone acetate （30 mg/d）, was administered consecutively for 5 days. Afterward, the dose was reduced to be 10 mg/d and the medication stopped after taking consecutively for 1 week. Muscular injection with vitamin B12 （0.5 mg） and B1 （0.1 mg） was given, once daily. 10 days later, vitamin B1 was taken for oral administration, 10 mg each time, three times a day, for 10 days totally. Before and after the treatment, the clinical effect was compared between the two groups in terms of the analysis on the Hourse-Brackman (H-B) grade of facial nerve function, the distance between the upper and the lower eyelids, muscle strength, degree of eyelid closure and electromyogram (EMG). RESULTS: The total effective rate of treatment group was 96.9 % (31/32), better than 84.4%（27/32） in the control group (P<0.05). After treatment, in the treatment group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex were all improved as compared with those before the treatment (P<0.01, P<0.05). In the control group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the latent period of motor nerve conduction and the blink reflex were all improved as compared with those before the treatment (P<0.01, P<0.05). After the treatment, the results of the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex in the treatment group were all better than those in the control group (P<0.05，P<0.01). CONCLUSION: The treatment with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62) greatly promotes the recovery of orbicularis oculi muscle in the patients with facial neuritis, reduces the complications and presents the satisfactory clinical effect.

Structural features and antioxidant activities of Chinese quince (Chaenomeles sinensis) fruits lignin during auto-catalyzed ethanol organosolv pretreatment.

Chinese quince fruits (Chaenomeles sinensis) have an abundance of lignins with antioxidant activities. To facilitate the utilization of Chinese quince fruits, lignin was isolated from it by auto-catalyzed ethanol organosolv pretreatment. The effects of three processing conditions (temperature, time, and ethanol concentration) on yield, structural features and antioxidant activities of the auto-catalyzed ethanol organosolv lignin samples were assessed individually. Results showed the pretreatment temperature was the most significant factor; it affected the molecular weight, S/G ratio, number of ß-O-4' linkages, thermal stability, and antioxidant activities of lignin samples. According to the GPC analyses, the molecular weight of lignin samples had a negative correlation with pretreatment temperature. 2D-HSQC NMR and Py-GC/MS results revealed that the S/G ratios of lignin samples increased with temperature, while total phenolic hydroxyl content of lignin samples decreased. The structural characterization clearly indicated that the various pretreatment conditions affected the structures of organosolv lignin, which further resulted in differences in the antioxidant activities of the lignin samples. These results can be helpful for controlling and optimizing delignification during auto-catalyzed ethanol organosolv pretreatment, and they provide theoretical support for the potential applications of Chinese quince fruits lignin as a natural antioxidant in the food industry.

[Jingjin needling improves facial nerve function and psychosomatic function in Hunt facial para-lysis patients].

OBJECTIVE: To observe the clinical effectiveness of Jingjin (muscle region) needling in the treatment of Hunt facial paralysis (HFP). METHODS: A total of 80 HFP patients were randomly divided into acupuncture and medication groups (n＝40 cases/group). Jingjin needling was applied to Yangbai(GB14) to Shangxing (GV23), Touwei (ST8), Cuanzhu (BL2), Sizhukong (TE23，penetrative needling), Dicang (ST4) to Jiache (ST6, penetrative needling), Yingxiang(LI20) and Xiaguan(ST7), Hegu(LI4), Yifeng (TE17), Yuyao (EX-HN 4), and Shenmai (BL62), with the needles retained for 30 min. The treatment was conducted once daily, with 10 consecutive days being a therapeutic course, and 3 courses altogether. Patients of the medication group received oral administration of Prednisone acetate (12 days), Acyclovir (7 days), intramuscular injection of Vitamin B12 and Vitamin B1(10 days), then, oral administration of Vitamin B1, successively. The therapeutic effect was assessed by using House-Brackman (H-B) facial function grading system (grade I to VI), traditional Chinese medicine (TCM) sign and symptom score, and facial disability index (FDI) scale including FDI physical function (FDIP, food and water swallowing, speaking-pronouncing, dryness or tearing, and mouth-opening) and FDI social function (FDIS, self-rating anxiety/depression scales), separately. RESULTS: After the treatment, the TCM symptom and sign scores for depth of nasolabial groove, nose shrugging, lower lip asymmetry, food retention and post-auricular pain were significantly lower in the medication group (P<0.05)．After the treatment, the TCM symptom and sign scores for frontal muscle movement, eyelid opening and closing, depth of nasolabial groove, nose shrugging, lower lip asymmetry, cheek blowing, food retention, latissimus cervicalis contraction, taste disorder, hearing hypersensitivity, tears and discomfort and post-auricular pain were significantly lower in the acupuncture group (P<0.05)．Comparison between two groups showed that the TCM symptom and sign scores for frontal muscle movement, eyelid opening and closing, depth of nasolabial groove, nose shrugging, lower lip asymmetry, cheek blowing, food retention, latissimus cervicalis contraction, taste disorder, hearing hypersensitivity, tears and discomfort and post-auricular pain were significantly lower in the acupuncture group than in the medication group(P<0.05)．The scores of FDIP and FDIS were significantly increased in both groups (P<0.01) and notably higher in the acupuncture group than in the medication group (P<0.01) after the treatment. The total effective rate of acupuncture group was 97.5% (39/40), and that of medication group was 72.5% (29/40). The therapeutic effect of the acupuncture group was significantly superior to that of the medication group (P<0.01)．. CONCLUSION: Jingjin needling has a good therapeutic effect in improving facial nerve function, psychosomatic function and clinical signs and symptoms in HFP patients, evidently being better than medication.

Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study.

OBJECTIVE: We aimed to investigate whether Chinese endoscopists without narrow-band imaging (NBI) experiences could achieve high accuracy in the real-time diagnosis of colorectal polyps using NBI International Colorectal Endoscopic (NICE) classification after web-based training. METHODS: Altogether 15 endoscopists from five centers with no NBI experiences followed a short, web-based training program on the NICE classification and took web-based test. Their performances were compared with 15 matched experienced endoscopists with no NBI experience who received no NBI training. These 15 trained endoscopists then made real-time diagnoses of colorectal neoplasia. A logistic regression was used to assess potential predictors of diagnostic performance. RESULTS: Compared with those who received no training, trained endoscopists achieved comparable overall accuracy (85.3% vs 83.1%, P = 0.408) and accuracy at a high-confidence level (87.0% vs 86.0%, P = 0.670), but had a higher confidence rate (86.1% vs 83.7%, P = 0.004) for the diagnosis of neoplasia. Real-time diagnostic accuracy, sensitivity and specificity were 94.3% (95% confidence interval [CI] 91.5%-96.2%), 96.2% (95% CI 93.4%-97.9%) and 85.3% (95% CI 74.8%-92.1%) at high-confidence level. The high-confidence level was the strongest predictor of real-time diagnostic accuracy (odds ratio 12.66, P < 0.001). CONCLUSIONS: Web-based training can improve the confidence level of endoscopists in accurately diagnosing colorectal polyps using the NICE classification. Chinese endoscopists can achieve high accuracy in diagnosing colorectal neoplasia at a high confidence level (ClinicalTrials ID: NCT02033980).

Combined Scores from the EncephalApp Stroop Test, Number Connection Test B, and Serial Dotting Test Accurately Identify Patients With Covert Hepatic Encephalopathy.

BACKGROUND & AIMS: The EncephalApp Stroop test is a high-sensitivity but low-specificity test that has been used to identify patients with covert hepatic encephalopathy (CHE). We aimed to develop a new strategy to detect CHE, combining EncephalApp Stroop test score with scores from subtests of the psychometric hepatic encephalopathy scoring system (PHES). METHODS: We performed a survey of 569 adult volunteers (229 men) in 9 communities in Shanghai, China, administering the EncephalApp Stroop test to determine the range of scores in the general population. Data from the standard PHES, including the number connection test-A, number connection test-B (NCT-B), line tracing test, serial dotting test (SDT), and digit symbol test, were used as the reference standard for diagnosis of CHE. A combination of the EncephalApp Stroop with subtests of the PHES was used to establish a new strategy for CHE diagnosis. We validated our findings using data from 160 patients with cirrhosis from 5 centers China. RESULTS: We determined the range of EncephalApp Stroop test scores for the volunteers of different decades of age, education levels, and sexes. Age, education level, and sex were independently associated with EncephalApp Stroop test scores. A combination of scores from the EncephalApp Stroop test, the NCT-B, and the SDT identified patients with CHE with the highest level of accuracy, when the standard PHES was used as the reference standard. A combination of scores of 187 sec for the EncephalApp Stroop test and below -1 for the NCT-B or below -1 for the SDT identified patients with CHE with an area under the curve (AUC) of 0.86, 81.0% sensitivity, and 91.9% specificity, and 87.5% accuracy. In the validation cohort, these cutoff scores identified patients with CHE with an AUC of 0.88, 97.1% sensitivity, 79.3% specificity, and 86.9% accuracy. The average time to calculate this score was 374±140 sec, compared 424±115 sec for the entire PHES. CONCLUSION: Scores from the EncephalApp Stroop test, NCT-B, and SDT identify patients with CHE with approximately 87% accuracy, and in a much shorter time than the standard PHES. This score combination could be a valid and convenient method for identifying patients with CHE. chictr.org.cn number, ChiCTR-EDC-17012007, ChiCTR1800019954.

Chinese guidelines on management of hepatic encephalopathy in cirrhosis.

The Chinese Society of Hepatology developed the current guidelines on the management of hepatic encephalopathy in cirrhosis based on the published evidence and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of hepatic encephalopathy (HE) including minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy, emphasizing the importance on screening MHE in patients with end-stage liver diseases. The guidelines emphasized that early identification and timely treatment are the key to improve the prognosis of HE. The principles of treatment include prompt removal of the cause, recovery of acute neuropsychiatric abnormalities to baseline status, primary prevention, and secondary prevention as soon as possible.

Prognostic value of long non-coding RNA breast cancer anti-estrogen resistance 4 in human cancers: A meta-analysis.

BACKGROUND: Since long non-coding RNA breast cancer anti-estrogen resistance 4 (lncRNA BCAR4) is dysregulated in various types of cancers, we conducted a meta-analysis to determine its prognostic value in cancer. METHODS: PubMed, EMBASE database, and CENTRAL were systematically searched.Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to estimate the prognostic value. Odds ratios (ORs) and their 95% CIs were used to assess the association between lncRNA BCAR4 expression and clinicopathological features, including tumor size, differentiation, lymph node metastasis, distant metastasis, and tumor stage. RESULTS: Ten studies with 890 patients were included in this meta-analysis. The pooled results indicated that high lncRNA BCAR4 expression was associated with poor overall survival (OS) (HR 2.80, 95% CI: 2.08-3.78; P < .001). Overexpression of lncRNA BCAR4 was related to lymph node metastasis (OR 3.68, 95% CI: 2.25-6.00; P < .001), high tumor stage (OR 3.19, 95% CI: 1.98-5.13; P < .001), and distant metastasis (OR 3.83, 95% CI: 2.15-6.82; P < .001), but not to tumor size. CONCLUSIONS: Therefore, lncRNA BCAR4 overexpression is associated with poor OS and advanced clinicopathological features, and lncRNA BCAR4 may be a novel prognostic biomarker in cancer patients. However, further high-quality studies are needed to confirm these findings.

Removal of phthalic acid esters from sea buckthorn (Hippophae rhamnoides L.) pulp oil by steam distillation and molecular distillation.

Sea buckthorn (Hippophae rhamnoides L.) pulp oils (SPOs) are rich in a variety of beneficial bioactive ingredients. Nevertheless, SPOs would be exposed to plastic equipment during processing, resulted in increasing phthalates contents and edible risk, as well as affecting oil quality. For these reasons, the effects of two stages steam distillation (SD2) and two stages molecular distillation (MD2) on phthalic acid esters (PAEs) content were investigated and compared in the present work. Compared with SD2, MD2 showed higher removal rates of seven selected PAEs from the SPO. Even if the initial concentration of DBP and DEHP in R-SPO were 1.626 and 10.933 mg/kg respectively, the concentration of DBP and DINP could be reduced below the limit set by China government after treated with MD2. Besides that, there was no trans-fatty acids generated in SPO during the distillation process.

Utility of the EncephalApp Stroop Test for covert hepatic encephalopathy screening in Chinese cirrhotic patients.

BACKGROUND AND AIM: Considering the large size of the potential population and limitations of common detection methods, covert hepatic encephalopathy (CHE) is difficult to screen for routinely. The present study aims to explore EncephalApp Stroop Test as a smartphone-based CHE screening tool in China. METHODS: A multicenter, single-visit study was carried out. The cutoff of the Chinese EncephalApp translation was determined by using Chinese standardized psychometric hepatic encephalopathy score (PHES) in cirrhotic patients as the gold standard. Indicators reflecting time required and number of tests on subtask on (naming the color of pound signs) and off (naming the color of the word in discordant coloring) were recorded, with the feedback from investigators and patients. RESULTS: One hundred forty-four patients were included; 58 (40.28%) patients were diagnosed with CHE by PHES. The cutoff of > 97.34 s for off time and > 186.63 s for on time + off time had the maximum area under the curve values (0.77) in all patients. Furthermore, with the cutoff of 186.63 s, on time + off time has the highest sensitivity (0.86). However, the specificity was unsatisfactory (0.59). Age and alcoholic hepatitis (odds ratio = 1.05 and 3.12, both P < 0.05) were positively correlated with the risk of CHE. The experience with electronic devices and education duration were negatively correlated (odds ratio = 0.21 and 0.92, both P < 0.05). Compared with PHES, EncephalApp represented 38% time saving. Furthermore, it was superior to PHES regarding accessibility, convenience, and acceptability by administrators (all P < 0.05). CONCLUSIONS: The EncephalApp Stroop Test is an efficient screening tool for CHE in Chinese cirrhotic patients.

Reduced exosome miR-425 and miR-744 in the plasma represents the progression of fibrosis and heart failure.

Heart failure creates a leading public health burden worldwide and cardiac fibrosis is a hallmark of pathological cardiac remodeling which was found in HF patients. In this study, we detected the expression of 9 candidate miRNAs in the plasma exosome samples from 31 HF patients, and found the level of miR-21, miR-425 and miR-744 was altered. The downregulation of miR-425 and miR-744 was also found in angiotensin II treated cardiac fibroblasts. Through functional study, we identified that the reduction of miR-425 and miR-744 relates to overexpression of collagen 1 and α-SMA, which result in fibrogenesis of cardiac fibroblasts. Conversely, overexpression of miR-425 or miR-744 in cultured cardiac fibroblasts significantly abrogates angiotensin induced collagen formation and fibrogenesis. Finally, we confirmed that TGFß1 is a direct target of miR-425 and miR-744 by dual luciferase assay and immunoblotting. Our data demonstrate that miR-425 and miR-744 function as negative regulators of cardiac fibrosis by suppression TGFß1 expression, and miR-425 and miR-744 level in the plasma exosomes has the potential to be a biomarker to predict cardiac fibrosis and heart failure.

Occurrence of deoxynivalenol in maize germs from North China Plain and the distribution of deoxynivalenol in the processed products of maize germs.

69 maize germ samples from North China Plain, 40 processed products of maize germs obtained in lab, 30 crude corn oils from factories and 40 refined corn oils from supermarkets in China were analyzed of deoxynivalenol (DON) by HPLC combined with ultraviolet detection and immunoaffinity column. 95.7% of maize germs were contaminated by DON. The average content was 449.0 µg/kg. The average of DON in processed products of maize germs including solvent extracted oil, cold-press oil, meal and cake was 163.7, 113.1, 1111.5 and 1175.2 µg/kg, respectively. Only 20% of crude corn oil and 12.5% of refined corn oil were contaminated by DON with the range of 67.5-340.5 µg/kg and 57.1-207.5 µg/kg, respectively. During the production of corn oil, solvent extraction oil had a larger amount of DON than pressing oil. The contamination of DON in corn oil was not serious or widespread, which indicated a low risk of health.

Optimization of Supercritical Carbon Dioxide Extraction of Eucommia ulmoides Seed Oil and Quality Evaluation of the Oil.

Supercritical carbon dioxide extraction (SC-CO2) technology was used to extract oil from Eucommia ulmoides seed. The optimum conditions and significant parameters in SC-CO2 were obtained using response surface methodology (RSM). The qualities of the extracted oil were evaluated by physicochemical properties, fatty acid composition, vitamin E composition. It was found that the optimum extraction parameters were at pressure of 37 MPa, temperature of 40°C, extraction time of 125 min and CO2 flow rate of 2.6 SL/min. Pressure, temperature and time were identified as significant parameter effecting on extraction yield. The importance of evaluated parameters decreased in the order of pressure > extraction time > temperature > CO2 flow rate. GC analysis indicated that E. ulmoides seed oil contained about 61% of linolenic acid and its fatty acid composition was similar with that of flaxseed oil and perilla oil. The content and composition of vitamin E was determined using HPLC. The E. ulmoides seed oil was rich in vitamin E (190.72 mg/100 g), the predominant vitamin E isomers were γ- tocopherol and δ- tocopherol, which accounted for 70.87% and 24.81% of the total vitamin E, respectively. The high yield and good physicochemical properties of extracted oil support the notion that SC-CO2 technology is an effective technique for extracting oil from E. ulmoides seed.

Characterization of a New α-Linolenic Acid-Rich Oil: Eucommia ulmoides Seed Oil.

Eucommia ulmoides seed oil is the main byproduct of E. ulmoides cultivation. To better understand its functions, E. ulmoides seed oil is characterized comprehensively in this work. The composition of E. ulmoides seed, physicochemical properties, thermal properties, fatty acid composition, triacylglycerol (TAG) composition and Vitamin E composition of E. ulmoides seed oil were determined. The results show that the E. ulmoides seed contained about 34.63% oil. The excellent physicochemical properties of E. ulmoides seed oil ensured it has a potential to be developed as an edible oil. The main fatty acids in E. ulmoides seed oil were linolenic acid (61.36%), oleic acid (17.02%), and linoleic acid (12.04%). HPLC-ELSD method determined that LnLnLn (37.99%), LnLnO (22.62%), LnLnL (14.5%), and LnLnP (8.78%) were the oil's major TAG components. The oil exhibited a unique thermal curve which contained 2 melting peaks at -38.45 and -22.22 °C, respectively. The total content of vitamin E in E. ulmoides seed oil was 190.96 mg/100g, which exist mainly in γ-tocopherol and δ-tocopherol isomer. Overall, the results indicated that E. ulmoides seed oil is a promising oil in food, pharmaceutics, cosmetics and other nonfood industries.

The association between metformin use and colorectal cancer survival among patients with diabetes mellitus: An updated meta-analysis.

OBJECTIVE: Recent studies have reported conflicting results on the correlation between metformin use and outcomes in patients with colorectal cancer (CRC). A meta-analysis was performed to evaluate the efficacy of metformin therapy on the prognosis of CRC patients with type 2 diabetes mellitus (T2DM). METHODS: We conducted a systematic search of PubMed, EMBASE, the Cochrane Library, and the Web of Science for related articles up to August 2016. Two investigators independently identified and extracted information. Pooled risk estimates [hazard ratios (HRs)] and 95% confidence intervals (CIs) were calculated using fixed-effects models. The risk of publication bias was assessed by examining funnel plot asymmetry as well as Egger's test and Begg's test. RESULTS: Of 81 articles identified, 8 retrospective cohort studies, representing 6098 cases of CRC patients with T2DM who used metformin and 4954 cases of CRC patients with T2DM who did not use metformin, were included in this meta-analysis. There was no significant heterogeneity and quality difference between studies. Metformin users had significantly improved overall survival (OS) (HR = 0.82, 95% CI: 0.77-0.87, P = 0.000). However, Metformin use cannot affect CRC-specific survival (HR = 0.84, 95% CI: 0.69-1.02, P = 0.079) compared to non-users. CONCLUSION: This meta-analysis suggests that metformin use may improve survival among CRC patients with T2DM. However, prospective controlled studies are still needed to rigorously evaluate the efficacy of metformin as an anti-tumor agent.