A Qualitative Exploration of Older Patients' Experiences With Frailty and Related Management Strategies.

BACKGROUND: Frailty is highly prevalent in hospitalized older patients and may increase the risk of adverse health outcomes. Understanding the experiences of older patients and the management strategies they use to recover from frailty is crucial to developing appropriate interventions. PURPOSE: This study was designed to explore the frailty experiences of older adults and the management strategies they use to recover from frailty. METHODS: Using purposive sampling, semistructured, face-to-face interviews were conducted with 16 older patients with frailty. Data were analyzed using content analysis. RESULTS: The experiences of participants were classified into three phases, including the (a) individual sensing phase, (b) daily-living-threatening phase, and (c) acclimatization and acceptance phase. When experiencing frailty, the participants developed management strategies to facilitate recovery, which manifested in three phases: (a) making flexible adjustments to the daily routine, (b) using adequate support systems, and (c) adopting positive thinking. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results indicate that familial support and positive thinking are important management strategies for successful recovery in frail individuals. Older patients require adequate support systems. Positive thinking was also found to be an effective management strategy for recovery. Healthcare professionals should not only focus on providing supportive resources but also provide support to older patients to facilitate their adoption of positive thinking to face life changes brought on by frailty.

Atropine 0.01% eye drops slow myopia progression: a systematic review and Meta-analysis.

AIM: To evaluate the effects of atropine 0.01% on slowing myopia progression. METHODS: We searched for relevant studies in the Cochrane Library, PubMed, Embase, Ovid, CBM, CNKI, VIP and Wan Fang Data in Chinese. A supplementary search was conducted in OpenGrey (System for Information on Grey Literature in Europe), the ISRCTN registry, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) from the dates of inception to June 30, 2018. RESULTS: Seven randomized controlled trials (RCTs) with a total of 1079 subjects were included (505 in the atropine 0.01% group and 574 in the control group). The results showed that the atropine 0.01% group exhibited significantly greater control of axial growth than the control group [MD=-0.12, 95%CI (-0.19, -0.06)]. There was also a statistically significant difference between the atropine 0.01% and control groups in the changes in axial length [MD=-0.14, 95%CI (-0.25, -0.03)], but the quality of evidence was low. There were no significant differences between the atropine 0.01% and control groups in the overall effect with respect to diopter value, change in diopter, distance vision and intraocular pressure [MD=0.08, 95%CI (-0.27, 0.42); MD=0.09, 95%CI (-0.17, 0.36); MD= -0.01, 95%CI (-0.02, 0.00); MD=0.08, 95%CI (-0.56,0.40)]. The sensitivity analysis showed that the conclusion of the Meta-analysis is relatively stable. With respect to adverse events, there were significant differences between the atropine 0.01% and control groups [OR=0.26, 95%CI (0.11, 0.61)]. CONCLUSION: Based on the available evidence, atropine 0.01% eye drops offer benefits in controlling axial growth and safety without causing significant differences in diopter values, distance vision and intraocular pressure.

Vip3Aa induces apoptosis in cultured Spodoptera frugiperda (Sf9) cells.

The vegetative insecticidal proteins (Vip) secreted by many Bacillus thuringiensis strains during their vegetative growth stage are regarded as second generation insecticidal proteins, as they share no sequence or structural homology with known crystal insecticidal proteins (Cry) and have a broad insecticidal spectrum. Compared with insecticidal crystal proteins (ICPs), the insecticidal mechanisms of Vips have been little studied. Here we investigated the mechanism responsible for Vip3Aa toxicity in cultured insect cells. Using, flow cytometry analyzes, TUNEL staining and DNA fragmentation assays, we show that Vip3Aa can induce apoptosis in Spodoptera frugiperda (Sf9) cells and cause cells to arrest at the G2/M phase. We also show that Vip3Aa can disrupt mitochondrial membrane potential (ΔΨm), leading to the activation of Sf-caspase-1, suggesting that a mitochondrial mediated and caspase dependent pathway may be involved in Vip3Aa-induced apoptosis in Sf9 cells.

YvoA and CcpA Repress the Expression of chiB in Bacillus thuringiensis.

Bacillus thuringiensis produces chitinases, which are involved in its antifungal activity and facilitate its insecticidal activity. In our recent work, we found that a 16-bp sequence, drechiB (AGACTTCGTGATGTCT), downstream of the minimal promoter region of the chitinase B gene (chiB) was a critical site for the inducible expression of chiB in B. thuringiensis Bti75. In this work, we show that a GntR family transcriptional regulator (named YvoABt), which is homologous to YvoA of Bacillus subtilis, can specifically bind to the drechiB oligonucleotide sequences in vitro by using electrophoretic mobility shift assays (EMSAs) and isothermal titration calorimetry (ITC) assays. The results of quantitative real-time reverse transcription-PCR (qRT-PCR) and Western blotting indicated that deletion of yvoA caused an ∼7.5-fold increase in the expression level of chiB. Furthermore, binding of purified YvoABt to its target DNA could be abolished by glucosamine-6-phosphate (GlcN-6-P). We also confirmed, in the presence of the phosphoprotein Hpr-Ser45-P, that purified CcpABt bound specifically to the promoter of chiB, which contains the "crechiB" sequence (ATAAAGCGTTTACA). According to the results of qRT-PCR and Western blotting, deletion of ccpA resulted in a 39-fold increase in the chiB expression level, and glucose no longer influenced the expression of chiB. We confirm that chiB is negatively controlled by both CcpABt and YvoABt in Bti75.

[Sexual reproductive allocation of Sargassum thunbergii at Taiping Cape of Yellow Sea].

This paper studied the dynamics of reproductive allocation (RA) of Sargassum thunbergii during its sexual reproductive season and the related environmental factors at the Taiping Cape of Yellow Sea. The sexual reproduction of S. thunbergii initiated in early June, peaked in mid July when the sea water temperature was about 22 degrees C (the mean proportion of biomass allocated to reproductive organs on July 19 was 76.7%), and ended in late August. The RA had a significant linear correlation with the average length of thallus branches (r = 0.855, P < 0.01). The thalli with a length less than 10 cm showed a lower RA in the whole sexual reproductive season, while the thalli longer than 10 cm had a RA up to averagely 70.0% at the peak maturing stage. UNIANOVA analysis showed that both tidal level and wave strength had significant effects on the RA of S. thunbergii (tidal level: F = 175.62, P < 0.01; wave strength: F = 95.35, P < 0.01), and there was a significant interaction between tidal level and wave strength (F = 9.14, P < 0.05). The sizes of the effects were in the order of tidal level > wave strength > tidal level x wave strength.

[Effectiveness of recombinant adenovirus p53 injection on laryngeal cancer: phase I clinical trial and follow up].

OBJECTIVE: To evaluate the efficacy and toxicity of recombinant adenovirus p53 injection (SBN-1) in patients with laryngeal cancer. METHODS: Twelve cases with laryngeal cancer, 11 males and 1 female, aged 59.5 +/- 12.4 years, were randomly divided into three groups of 4 patients. The patients received intratumor injection of SBN-1 at the dosage of 1 x 10(10)VP, 1 x 10(11)VP, or 1 x 10(12)VP once every other day for 2 courses of treatment with 5 times of injection as one course of treatment. Two days after the injection the patients were operated on. After the operation SBN-1 of the same doses was injected around the tumor bed. The patients were followed up for more than 3 years by correspondence and out-patient department examinations. ELISA was used to detect the serum anti-adenoviral IgG and IgM, and interleukin-2 receptor (IL-2R). Immunohistochemistry was used to examine the expression of p53 protein in the tumor tissues. Flow cytometry was used to examine the T cell subgroup. The symptoms and side effects were observed. RESULTS: One patient in the 10(12)VP group presented self-limited fever (38.2-38.6 degrees C) and no other abnormality was observed after the SBN-1 injection. Specific antibody to SBN-1 turned from negative to positive two or three weeks after the first injection. P53 protein expression was significantly enhanced in tumors after injection of SBN-1. The serum level of IL-2R was 750 +/- 401 pg/ml before treatment and 552 +/- 203 pg/ml after treatment. The numbers of CD3, CD4, and CD8 were 66 +/- 10, 41 +/- 15, and 32 +/- 10 respectively before the treatment and were 67 +/- 9, 43 +/- 8, and 34 +/- 16 respectively after treatment, and the CD4/CD8 ratio was 1.4 +/- 0.6 before the treatment and was 1.6 +/- 0.9 after treatment. The abnormality in SIL-2R level and the disorder of T cell subgroup were improved in 2 cases. Followed up for over 3 years showed that all cases still lived free of cancer. CONCLUSION: Safe and effective on laryngeal cancer without obvious adverse events, local injection of SBN-1 is a promising treatment.