[Influencing factors of hypertension and diabetes care cascade: a qualitative study].

Objective: Employing the cascade care model, this qualitative study explores determinants influencing the cascading care stages of hypertension and diabetes by interviewing various stakeholders. Methods: In July 2023, purposive sampling was employed to recruit participants from Gongyi and Wugang cities in Henan Province, and Linqu County in Weifang City, Shandong Province. Semi-structured in-depth interviews were conducted with representatives of policymakers, healthcare institution managers, providers, and patients with hypertension and diabetes.And thematic analysis was performed using both inductive and deductive approaches. Results: A total of 82 individuals were interviewed, with an age range of (53.8±12.0) years, among which 48 (58.5%) were male; including 5 policymakers, 10 institutional managers, 20 healthcare providers, and 47 patients with hypertension and diabetes. The study identified both barriers and facilitating factors at the patient, healthcare provider, and system levels across various stages: awareness, screening, diagnosis, treatment, long-term management, and control of hypertension and diabetes. Conclusion: By delineating and analyzing the barriers and facilitators at each stage of hypertension and diabetes care, this study lays the groundwork for the development of effective, feasible, and sustainable implementation pathways, with significant implications for the enhanced management of hypertension and diabetes in China.

Preparation and process optimization of microbial organic copper as a feed additive / Preparação e otimização do processo de cobre orgânico microbiano como aditivo alimentar

As an essential trace element for animals, copper significantly contributes to the growth and health of animals. Compared to inorganic trace elements, organic trace elements are better supplements; notably, they are acquired through microbial transformation. Therefore, we screened for copper-enriched microorganisms from high copper content soil to obtain organic copper. Sodium diethyldithio carbamate trihydrate was applied as a chromogenic agent for determining micro amounts of intracellular copper through spectrophotometry. In total, 50 fungi were isolated after the successful application of the screening platform for copper-rich microbes. Following morphological and molecular biology analyses, the N-2 strain, identified as Aspergillus niger sp. demonstrated showed better copper enrichment potential than others. Notably, the strain tolerance to copper was nearly thrice that of Saccharomyces cerevisiae, up to 1600mg/L. The content of the organic bound copper was 22.84mg Cu/g dry cell. Using the Central Composite Design (CCD) response surface method, we optimized the fermentation condition (inoculation amount, 13%; temperature, 28(C; pH, 5.0). Compared to the original strain results under the single factor fermentation condition, we reported an increase by 24.18% under the optimized conditions. Collectively, these findings provide a reference for uncovering new and low-cost organic copper additives.(AU)

Como elemento traço essencial para os animais, o cobre contribui significativamente para o crescimento e saúde dos animais. Comparado aos oligoelementos inorgânicos, os oligoelementos orgânicos são melhores suplementos; notavelmente, eles são adquiridos através de transformação microbiana. Portanto, nós selecionamos microorganismos enriquecidos com cobre de solos com alto teor de cobre para obter cobre orgânico. O carbamato de sódio diethyldithio trihidratado foi aplicado como agente cromogênico para a determinação de micro quantidades de cobre intracelular através da espectrofotometria. No total, 50 fungos foram isolados após a aplicação bem sucedida da plataforma de triagem para micróbios ricos em cobre. Após análises morfológicas e de biologia molecular, a cepa N-2, identificada como Aspergillus niger sp. demonstrou um melhor potencial de enriquecimento de cobre do que outras. Notavelmente, a tolerância da estirpe ao cobre foi quase três vezes maior que a da Saccharomyces cerevisiae, até 1600mg/L. O conteúdo de cobre ligado orgânico era de 22,84mg Cu/g de célula seca. Usando o método de superfície de resposta Central Composite Design (CCD), nós otimizamos a condição de fermentação (quantidade de inoculação, 13%; temperatura, 28C; pH, 5,0). Em comparação com os resultados da deformação original sob a condição de fermentação de fator único, relatamos um aumento de 24,18% sob as condições otimizadas. Coletivamente, estas descobertas fornecem uma referência para descobrir novos aditivos de cobre orgânico de baixo custo.(AU)

Impact of postoperative pituitary tumor adrenal insufficiency and hormone replacement therapy (HRT) on tumor recurrence.

OBJECTIVE: The present study was aimed to investigate the impact of postoperative pituitary tumor adrenal insufficiency and hormone replacement therapy (HRT) on tumor recurrence. PATIENTS AND METHODS: The prospective study included 143 pituitary tumor patients as study subjects. Within 6 months after the operation, the study was planned to explore differences (if any) between the tumor recurrence rate of patients treated with hormone replacement therapy and the patients without hormone replacement therapy. Also, the relation of tumor reoccurrence was studied with pituitary tumor adrenal insufficiency. RESULTS: The age, gender of patients as well as the size of the tumor had no significant correlation with postoperative pituitary tumor adrenal insufficiency. Further, the short-term follow-up lasting for 0.5 to 2.5 years after the operation, the hormone replacement therapy of hydrogenation had no significant impact on tumor recurrence rate. CONCLUSIONS: The age, patient gender and the size of the tumor were not independent risk factors leading to postoperative pituitary tumor adrenal insufficiency. However, the occurrence rate of adrenal insufficiency of patients in high age group was higher than that of patients in low age group. Also, the occurrence rate of adrenal insufficiency of patients (whose one or several hormones dramatically decreased before the operation) was significantly higher than that of patients (whose hormone level did not decrease before the operation). So, the patients in high age group and whose one or several hormones dramatically decreased before the operation should be paid more attention to the condition of adrenal insufficiency and should be ready for hormone replacement.

Evaluating biofilm growth of two oral pathogens.

AIMS: To determine the expediency of a microtitre assay system for establishing, quantifying and antimicrobial testing of two representative oral pathogens. METHODS AND RESULTS: Streptococcus mutans and Porphyromonas gingivalis were used. Morphological characteristics of the attached population were evaluated. Biofilm growth was evaluated spectrophotometrically (undisturbed and 1 N NaOH dissipated biofilm). The minimum concentration of chlorhexidine gluconate that inhibited biofilm growth was determined. Growth of the biofilms was successfully monitored by direct optical density measurements or those re-suspended in 1 N NaOH. The latter was necessary when glucans were present in Strep. mutans biofilms. The minimum concentration of chlorhexidine gluconate that inhibited biofilm growth was 1.25 microg ml(-1) for both species. The attached bacteria exhibited common biofilm characteristics. SIGNIFICANCE AND IMPACT OF THE STUDY: The assay system developed was especially useful for monitoring the growth of adherent Strep. mutans in the presence of glucans, which is particularly significant for the study of anti-plaque chemicals.

Namibian chewing stick, Diospyros lycioides, contains antibacterial compounds against oral pathogens.

The twigs of Diospyros lycioides, a plant commonly known as "muthala", are frequently used as chewing sticks for the cleaning of teeth by rural and urban people in Namibia. Preliminary studies showed that a methanol extract of D. lycioides inhibited growth of selected oral pathogens. Subsequent bioassay-guided fractionation led to the isolation of four novel bioactive naphthalene glycosides, diospyrosides A, B, C, and D (1-4), and two known bioactive naphthoquinones, juglone (5) and 7-methyljuglone (6). The structures of the new compounds were elucidated using spectroscopic techniques including 1D and 2D NMR. These compounds inhibited the growth of oral cariogenic bacteria (Streptococcus mutans and Streptococcus sanguis) and periodontal pathogens (Porphyromonas gingivalis and Prevotella intermedia) at minimum inhibitory concentrations ranging from 0.019 to 1.25 mg/mL. Juglone exhibited the strongest inhibitory activity among these compounds.

Proteolysis and utilization of albumin by enrichment cultures of subgingival microbiota.

Subgingival dental plaque consists mainly of microorganisms that derive their energy from amino acid fermentation. Their nutrient requirements are met by the subgingival proteolytic system, which includes proteases from microorganism and inflammatory cells, and substrate proteins from sulcus exudate, including albumin. To determine the selective effect of individual proteins on microbiota, we used albumin as the main substrate for growth. Eight subgingval plaque samples from untreated periodontal pockets of patients with adult periodontitis were inoculated in peptone yeast medium with bovine albumin (9 g/l). After three subculture steps, cell yields of the enrichment cultures at the medium with 0, 1.25, 2.5, 5, 10, and 20 g/l albumin were determined. Proteolytic activity (U/absorbance at 550 nm) of the enrichment cultures and different isolates derived from the cultures was estimated by the degradation of resorufin-labeled casein. It was observed that the yield of the mixed culture was albumin limited, and the proteolytic activities of the cultures in albumin broth were higher than in control (peptone broth). Among the isolates from the enrichment cultures, Peptostreptococcus micros, Prevotella melaninogenica, Prevotella buccae and Prevotella bivia demonstrated proteolysis. The frequent occurrence of Streptococcus gordonii and Streptococcus anginosus in the albumin cultures is explained by their ability to utilize arginine as an energy source for growth. Albumin in the medium was partly degraded by pure cultures but completely consumed in enrichment cultures, indicating synergy of bacterial proteinases. It is concluded that the subgingival microbiota possesses proteolytic activity and may use albumin as a substrate for their growth. Enrichment cultures on albumin may serve as a relatively simple in vitro model to evaluate the effects of proteinase inhibitors.

[A study on resorbable local metronidazol delivery devices]

A local metronidazol (MTZ) delivery using resorbable base material was studied. In vitro MTZ was almost completely released within 24 hrs from the hydroxypropylmethyl cellullouse(HPMC) strips.In vivo,release of the drug strips was also measured in six patients who had deep pockets of more than 5mm.MTZ-containing HPMC strip was inserted in the pocket.The average amount of MTZ in the gingival crevicalar fluid(GCF) 24 hrs after insertion of strip was 40microg/ml.(much higher than the reported MIC of some microorganisms associated with adult periodontitis).In vitro there were significant inhibitory effects of MTZ containing strips on the microorganisms associated with periodontal disease.The prevalence of spirochetes and motil rods,and gingival index(GI) was remarkably reduced in the MTZ administered pockets,It is suggest that this new direct drug delivery system with HPMC used as base material could be used to treat periodontal disease.