Evaluating the impact of personalized rehabilitation nursing intervention on postoperative recovery of respiratory function among thoracic surgery patients: A protocol for systematic review and meta-analysis.

BACKGROUND: Owing to clinical developments and economic strain, perioperative care has undergone considerable changes. Therefore, it is important to review and critique the efficacy of existing practices in a context that is placing increasing emphasis on better efficacy and cost-containment. Considering that the objective involves devising approaches to minimize postoperative complications and reduce medical care, efforts should concentrate on postsurgical pulmonary complications that are common. The present analysis aims to examine how customized rehabilitation nursing intercession impacts the postsurgical restoration of respiratory functions in thoracic surgery patients. METHODS: Prespecified search strategies will be employed to perform a methodological search of 6 databases namely EMBASE, Cochrane Library, PubMed, Web of Science, WanFang Database, and China National Knowledge Infrastructure. The analysis will comprise original publications that evaluated how personalized rehabilitation nursing intervention impacts postsurgical restoration of respiratory function in those who have undergone thoracic surgery. All considered publications are before December 25, 2021. Different authors will conduct an independent study selection process to evaluate the quality of the publications and extract required data. Based on the standardized mean difference and its 95% confidence interval, we estimate the summary effects for each meta-analyses. Based on heterogeneity in considered articles, the related data will be pooled through either a random- or fixed-effect meta-analysis. Lastly, the overall quality of evidence using appropriate methods will be performed. RESULTS: The results of this analysis will systematically evaluate how customized rehabilitation nursing interference impact postsurgical healing of respiratory functions in patients who have undergone thoracic surgery by collecting the existing evidence. ETHICS AND DISSEMINATION: Not required. OPEN SCIENCE FRAMEWORK REGISTRATION NUMBER: 10.17605/OSF.IO/NBVYW.

Use of metoclopramide in the first trimester and risk of major congenital malformations: A systematic review and meta-analysis.

BACKGROUND: Nausea and vomiting of pregnancy affects up to 80% of pregnant women, it typically occurs during the first trimester which is the most sensitive time for environmental exposures given organogenesis. Metoclopramide is an antiemetic drug used widely during NVP, but the findings of studies evaluating its safety of use in pregnancy is inconsistent. Therefore, we conducted a systematic review and meta-analysis to assess whether metoclopramide use during first trimester of pregnancy is associated with the risk of major congenital malformations. METHODS: The systematic search using database included Pubmed, Embase, Web of science, and Cochrane library. Studies written in English, comprising with an exposed group and a control group, reporting major congenital malformation as an outcome were included. RESULTS: Six studies assessing a total number of 33374 metoclopramide-exposed and 373498 controls infants were included in this meta-analysis. No significant increase in the rate of major congenital malformation was detected following metoclopramide use during first trimester (OR, 1.14; 95% CI, 0.93-1.38). CONCLUSIONS: Metoclopramide use during first trimester of pregnancy was not associated with the risk of major congenital malformations.

A Preliminary Study of Uric Metabolomic Alteration for Postpartum Depression Based on Liquid Chromatography Coupled to Quadrupole Time-of-Flight Mass Spectrometry.

Postpartum depression affects about 10-20% of newly delivered women, which is harmful for both mothers and infants. However, the current diagnosis of postpartum depression depends on the subjective judgment of a practitioner, which may lead to misdiagnosis. Hence, an appended objective diagnosis index may help the practitioner to improve diagnosis. A metabolomic study can find biomarkers as an objective index to facilitate disease diagnosis. Forty-nine postpartum depressed patients and 50 healthy controls were recruited into this study. The metabolites in urine were scanned with LC-Q-TOF-MS. The metabolomic data were analyzed with a multivariate statistical analysis method. Data from 40 patients and 40 controls were used for partial least square-discriminate analysis (PLS-DA). The urine metabolomic profiles of patients were different from those of controls. The PLS-DA model was validated by a permutation test, and the model could accurately classify the other 9 patients and 10 controls in T-prediction. Ten differentiating metabolites were found as main contributors to this difference, which are involved in amino acid metabolism, neurotransmitter metabolism, bacteria population, etc. Some of these potential biomarkers, such as 4-hydroxyhippuric acid, homocysteine, and tyrosine, showed relatively high sensitivities and specificities. The metabolic profile alteration induced by postpartum depression was found, and some of the differentiating metabolites may serve as biomarkers to facilitate the diagnosis of postpartum depression.

Lx2-32c inhibits the formation of mammosphere from MDA-MB-231 cells and induces apoptosis involving in down-regulating FoxM1.

Cancer stem cells (CSCs) are a subset of cancer cells which have self-renewal ability and exist in various tumors. Inhibition of CSCs self-renewal is considered as a new method for tumor therapy. A novel semi-synthetic taxane analogue, Lx2-32c, could overcome drug resistance in various cancer cell lines. In this study, it was found that Lx2-32c inhibited the proliferation and mammosphere formation of MDA-MB-231-derived cancer stem cell-like cells (MCSCLCs) and induced apoptosis, as well as down-regulated the expression of FoxM1 and CD44 in MCSCLCs. Simultaneously, it was proved that Lx2-32c combined with thiostreption, a FoxM1 inhibitor inhibited proliferation and mammosphere formation of MCSCLCs and induced apoptosis to a more extent than Lx2-32c alone; thiostreption could also enhance the effect of Lx2-32c of reduction of the expression of FoxM1 and CD44. All of these results indicated that Lx2-32c is a novel semi-synthetic taxane analogue which inhibits the self-renewal of MCSCLCs cells and induces apoptosis involving in down-regulating FoxM1.

LC-Q-TOF-MS based plasma metabolomic profile of subclinical pelvic inflammatory disease: A pilot study.

BACKGROUND: No index for non-invasive diagnosis of subclinical pelvic inflammatory disease (PID) is available at this time. Here we carried out a plasma metabolomic study to search for potential biomarkers to facilitate its non-invasive diagnosis. METHOD: The metabolites in plasma were detected by using an LC-Q-TOF-MS method. The metabolic profiles of subclinical PID patients and healthy controls were discriminated by multivariate analysis. 30 patients and 28 controls were enrolled for PLS-DA model construction, and further 8 patients and 8 controls were employed for model validation. Univariate analysis was performed to evaluate potential biomarkers. RESULTS: The metabolic profiles of subclinical PID patients were different from those of healthy controls in a PLS-DA model, and this model was validated by permutation test and could accurately classify further 16 samples in T-prediction. Eleven differentiating metabolites, with the variable importance in the project >1 and corrected P < 0.05, were found as potential biomarkers. These metabolites included eight lipids, p-cresol, 3-indolepropionic acid and indoxylsulfuric acid. Among them, lysophosphatidic acid (16,0/0:0) showed a highest AUC value of receiver operating characteristic curve (0.855), with sensitivity of 89.3% and specificity of 73.3%. CONCLUSION: Through an LC-Q-TOF-MS based metabolomic analysis on subclinical PID, this study reports the potential plasma biomarkers which may be helpful for its non-invasive diagnosis.

The association of genetic variations in DNA repair pathways with severe toxicities in NSCLC patients undergoing platinum-based chemotherapy.

Genetic variations in genes involved in repairing platinum-induced DNA lesions may contribute to the toxicity of platinum-based chemotherapy. The role of single-nucleotide polymorphisms (SNPs) within DNA repair pathways in the occurrence of severe toxicity is not yet understood. Current studies prefer to do original works rather than analyze previously published data. Our study aimed to replicate associations between previously investigated SNPs and toxicities and to identify new genetic makers. We systematically examined the relevance of 97 SNPs in 54 candidate genes responsible for repairing DNA interstrand and intrastrand cross-links to severe toxicity in a discovery cohort of 437 NSCLC patients receiving platinum-based chemotherapy. Statistically significant SNPs were then assessed for replication in an independent validation cohort of 781 NSCLC patients. We found that 7 SNPs were significant at p < 0.01 (RRM1 rs12806698, XPC rs2228000, XPF rs1799801, hMLH1 rs1800734, PMS2 rs1062372, REV3L rs462779 and FANCC rs4647554) in the discovery cohort. Among them, two SNPs (RRM1 rs12806698 and hMLH1 rs1800734) remained significant after Bonferroni correction. XPC rs2228000 showed a significant relationship with severe gastrointestinal toxicity in the validation cohort. When the two cohorts were combined, XPC rs2228000 presented better tolerance of severe hematologic toxicity, gastrointestinal toxicity and leukopenia (OR = 0.677, 95% CI: 0.510-0.899, p = 0.007; OR = 0.565, 95% CI: 0.368-0.869, p = 0.009; OR = 0.628, 95% CI: 0.439-0.899, p = 0.011, respectively). Our findings can offer comprehensive pharmacogenetic information for platinum-induced toxicities.

Rhizoma Smilacis Glabrae inhibits pathogen-induced upper genital tract inflammation in rats through suppression of NF-κB pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Rhizoma Smilacis Glabrae (RSG) is traditionally used to treat gynecological disease, which is simply recorded in Chinese Pharmacopoeia. However, whether it has effect on upper genital tract inflammation (UGTI) is unclear. AIM OF THE STUDY: To evaluate the pharmacological effect of RSG on UGTI in rats and analyze its phytochemistry characteristics. MATERIALS AND METHODS: The substances in RSG extract was qualified by LC-Q-TOF-MS method, and 11 substances were further quantified. The RSG extract, at dose of 241, 482 (clinical dose) and 964mg/kg/day, was orally administered to UGTI rats whose upper genital tracts were multi-infected with pathogens. Infiltrations of neutrophil and lymphocyte and productions of IL-1ß, IL-6, CXCL-1, MCP-1, RANTES, PGE2, COX-2, NF-κB p65 and IκB-α in upper genital tract were examined to evaluate the effects of RSG and its potential mechanism. RESULTS: A total of 77 substances were detected in RSG extract, with 50 substances putatively identified, most of which were flavonoids, phenolic acids and phenylpropanoids. The quantification analysis showed flavonoid had a relative high amount. In pharmacological study, RSG extract suppressed infiltrations of inflammatory cells, reduced over-productions of factors involved in inflammation and pelvic pain. A potential mechanism of these effects was blocking NF-κB signal pathway. CONCLUSIONS: The RSG extract exhibited anti-inflammatory effect on UGTI, with a potential mechanism of blocking the activation of NF-κB signal pathway. The effect may be involved in the presence of substances, such as flavonoids and phenolic acids.

The anti-inflammatory effect of Andrographis paniculata (Burm. f.) Nees on pelvic inflammatory disease in rats through down-regulation of the NF-κB pathway.

BACKGROUND: Andrographis paniculata (Burm. f.) Nees (APN), a principal constituent of a famous traditional Chinese medicine Fukeqianjin tablet which is used for the treatment of pelvic inflammatory disease (PID), has been reported to have anti-inflammatory effect in vitro. However, whether it has pharmacological effect on PID in vivo is unclear. Therefore, the aim of this study is to test the anti-inflammatory effect of APN and illuminate a potential mechanism. METHODS: Thirty-six female specific pathogen-free SD rats were randomly divided into control group, PID group, APN1 group, APN2 group, APN3 group and prednisone group. Pathogen-induced PID rats were constructed. The APN1, APN2 and APN3 group rats were orally administrated with APN extract at different levels. The prednisone group rats were administrated with prednisone. Eight days after the first infection, the histological examination of upper genital tract was carried out, and enzyme-linked immunosorbent assay (ELISA) was carried out using homogenate of the uterus and fallopian tube. Furthermore, immunohistochemical evaluations of NF-κB p65 and IκB-α in uterus was conducted. RESULTS: APN obviously suppressed the infiltrations of neutrophils and lymphocytes, and it could significantly reduce the excessive production of cytokines and chemokines including IL-1ß, IL-6, CXCL-1, MCP-1 and RANTES in a dose-dependent manner. Furthermore, APN could block the pathogen-induced activation of NF-κB pathway. CONCLUSION: APN showed potent anti-inflammatory effect on pathogen-induced PID in rats, with a potential mechanism of inhibiting the NF-κB signal pathway.

Gas chromatography-mass spectrometric method-based urine metabolomic profile of rats with pelvic inflammatory disease.

Pelvic inflammatory disease (PID) can lead to a poor outcome of severe sequelae, and the current methods of clinical diagnosis are not satisfactory. Metabolomics is an effective method for the identification of disease-related metabolite biomarkers to facilitate disease diagnosis. However, to the best of our knowledge, no PID-associated metabolomic study has yet been carried out. The metabolomic changes of rats with PID were investigated in the present study. A PID model was constructed by the multi-pathogenic infection of the upper genital tract in rats. Infiltration of inflammatory cells and elevated expression levels of the cytokines interleukin (IL)-1ß and IL-6 in the uterus and fallopian tubes validated the disease model. Gas chromatography-mass spectrometry coupled with derivatization was used to determine the urine metabolomic profile. Principal component analysis and partial least squares-discriminant analysis of the data sets showed a clear separation of metabolic profiles between rats with PID and control rats. Eighteen differentiating metabolites were found, including four amino acids, three fatty acids, nine organic acids, and two sugars, which indicated alterations in sugar metabolism, the citric acid cycle, amino acid metabolism and fatty acid metabolism. These metabolites could be potential biomarkers of PID, and this research may offer a new approach to evaluate the effect of anti-PID drugs in pre-clinical or clinical trials.

Metabolomic Study on the Preventive Effect of Patrinia scabiosaefolia Fisch on Multipathogen Induced Pelvic Inflammatory Disease in Rats.

Patrinia scabiosaefolia Fisch (PSF), a well-known traditional Chinese medicine (TCM), has been used as a "heat-clearing and detoxifying" agent. The present study was to illustrate the preventive effect of PSF on pelvic inflammatory disease (PID) in rats. The PID model was constructed by multipathogen infection of the upper genital tract with reference to the method previously reported. Urine metabolomic analysis was conducted with a GC-MS coupled with derivatization method. In this study, PID rats showed obvious infiltration of inflammatory cells and elevated expression of cytokines (IL-1ß and IL-6) in upper genital tract, compared with control rats. Sixteen differentiating metabolites contributed to the alteration of metabolic profile in PID rats, including two amino acids, three fat acids, nine organic acids, and two types of sugars. The rats, infected by multipathogen and administered with PSF, showed decreased infiltration of inflammatory cells and lowered expression of cytokines in upper genital tract, compared with PID rats. Meanwhile, PSF intervened in the PID-associated alterations in TCA cycle, sugar metabolism, amino acid metabolism, and other uncertain metabolic pathways. These results indicate that PSF has preventive effect on multipathogen induced PID and holistic interventional effect on disease-associated metabolomic change.