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In this hospital-based cross-sectional analytic study, we retrospectively reviewed clinical data of patients with acute ischemic stroke (AIS) between January 2017 and April 2023. Atrial cardiopathy was defined as any presence of the following: left atrial diameter ≥ 52 mm (males) or ≥ 47 mm (females), elevated P-wave terminal force in V1 > 5000 µV ms, or serum N terminal pro B type natriuretic peptide > 250 pg/ml. Initial stroke severity was defined by the National Institutes of Health Stroke Scale (NIHSS; moderate-to-severe, ≥ 5; and severe, ≥ 15). Univariate and multivariate binary logistic regression analyses were performed to assess the association between atrial cardiopathy and stroke severity. Among 662 AIS patients (mean age 70 years [interquartile range 61-78], 31.3% women), 303 (45.8%) had atrial cardiopathy. Multivariable logistic regression analysis showed that the presence of atrial cardiopathy was significantly associated with a higher odd of moderate-to-severe stroke (adjusted odds ratio [OR] 2.16, 95% confidence interval [CI] 1.46-3.20, p < 0.001) and severe stroke (adjusted OR 4.89, 95%CI 2.45-9.76, p < 0.001). This association remained significant in a sensitivity analysis excluding those with atrial fibrillation or coronary artery disease. Findings of the current study revealed that the association of atrial cardiopathy was with initial stroke severity independent of atrial fibrillation and was even confirmed in patients without atrial fibrillation; future studies to explore improved stroke prevention strategies for patients with atrial cardiopathy are needed.
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AVC Isquêmico , Índice de Gravidade de Doença , Humanos , Feminino , Masculino , Idoso , AVC Isquêmico/etiologia , Pessoa de Meia-Idade , Estudos Transversais , Estudos Retrospectivos , Átrios do Coração/fisiopatologia , Átrios do Coração/patologia , Fatores de Risco , Fibrilação Atrial/complicaçõesRESUMO
Background: Whether the relationship of intracerebral bleeding risk with lipid profile may vary by sex remains unclear. This study aims to investigate potential sex differences in the association between lipid profile and the risk of symptomatic intracerebral hemorrhage (sICH) in patients with acute ischemic stroke (AIS) who received intravenous thrombolysis using recombinant tissue plasminogen activator (r-tPA). Methods: This multicenter retrospective observational study analyzed patients with AIS treated with intravenous r-tPA. sICH was defined as a worsening of 4 or higher points in the National Institutes of Health Stroke Scale (NIHSS) score within 36 hours after intravenous thrombolysis in any hemorrhage subtype. We assessed the odds ratio (OR) with 95% confidence interval (CI) of lipid profile for sICH for each sex using logistic regression models adjusted for potential confounding factors. Results: Of 957 participants (median age 68 (interquartile range, 59-75), men 628 (65.6%)), 56 sICH events (36 (5.7%) in men and 20 (6.1%) in women) were observed. The risk of sICH in men decreased with increasing serum levels of triglyceride after adjustment for confounding factors (vs lowest tertile, medium tertile OR 0.39, 95% CI [0.17-0.91], top tertile OR 0.33, 95% CI [0.13-0.84], overall p = 0.021; per point increase, adjusted OR 0.29, 95% CI [0.13-0.63], p = 0.002). Neither serum levels of total cholesterol nor low-density lipoprotein (LDL) was associated with sICH in men. In women, there was no association between any of the lipid levels and the risk of sICH. Conclusions: This study indicated that the association between serum levels of triglyceride and sICH may vary by sex. In men, increased triglyceride levels decrease the risk of sICH; in women, this association was lost. Further studies on the biological mechanisms for sex differences in stroke risk associated with triglyceride are needed.
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Hemorragia Cerebral , AVC Isquêmico , Ativador de Plasminogênio Tecidual , Triglicerídeos , Humanos , Masculino , Feminino , Estudos Retrospectivos , Idoso , Triglicerídeos/sangue , Pessoa de Meia-Idade , AVC Isquêmico/tratamento farmacológico , AVC Isquêmico/sangue , AVC Isquêmico/epidemiologia , Hemorragia Cerebral/sangue , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/epidemiologia , Ativador de Plasminogênio Tecidual/efeitos adversos , Ativador de Plasminogênio Tecidual/administração & dosagem , Fatores Sexuais , Fatores de Risco , Terapia Trombolítica/efeitos adversos , Fibrinolíticos/efeitos adversos , Fibrinolíticos/administração & dosagem , Fibrinolíticos/uso terapêuticoRESUMO
Background: Oxidative stress and chronic inflammation play an important role in the pathogenesis process of cognitive frailty (CF). Regular Baduanjin exercise could improve cognitive frailty in older adults, but it is unclear whether the effect of Baduanjin exercise on improving CF is mediated by modulating circulating oxidative stress and inflammatory process. Method: A total of 102 community-dwelling older adults with CF were recruited and randomly allocated into a 24-week Baduanjin exercise training group or no specific exercise intervention control group at an equal rate. Cognitive function and physical frailty index were assessed using the Montreal Cognitive Assessment (MoCA) and the Edmonton Frail Scale (EFS), as well as the oxidative stress and inflammatory cytokines were measured at baseline and after intervention. Result: After 24 weeks of intervention, the increased MoCA score (2.51 ± 0.32 points, p < 0.001) and the decreased EFS scores (1.94 ± 0.20 points, p = 0.012) in the Baduanjin group were significantly higher than those in the control group. Serum antioxidant SOD levels were increased by 10.03 ± 4.73 U/mL (p < 0.001), and the prooxidative MDA and 8-iso-PGF2α levels were decreased by -1.08 ± 0.80 nmol/mL (p = 0.030) and -86.61 ± 15.03 ng/L (p < 0.001) in the Baduanjin training group; while inflammatory cytokines IFN-γ, IL-2 and IL-4 levels were increased (1.08 ± 0.33 pg./mL, p = 0.034, 2.74 ± 0.75 pg./mL, p = 0.04 and 1.48 ± 0.35 pg./mL, p = 0.042). In addition, a mediation effect that Baduanjin training improved cognitive ability mediated by an increase of circulating IFN-γ and IL-2 levels were observed in this study. Conclusion: Regular Baduanjin exercise training could improve the cognitive frailty of the community-dwelling older adults with CF, and modulate oxidative stress and inflammatory processes by reducing circulating pro-oxidative MDA and 8-iso-PGF2α levels and increasing anti-oxidative SOD levels, as well as impacting inflammatory cytokines IFN-γ, IL-2, and IL-4 levels. Nevertheless, the mechanism of Baduanjin exercise mediating oxidative stress and inflammatory processes should be cautious to be explained. Clinical trial registration: http://www.chictr.org.cn/index.aspx, ChiCTR1800020341.
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Inflamação , Estresse Oxidativo , Humanos , Idoso , Feminino , Masculino , Inflamação/sangue , Citocinas/sangue , Cognição/fisiologia , Idoso de 80 Anos ou mais , Fragilidade , Terapia por Exercício/métodos , Idoso Fragilizado , Qigong , Exercício Físico/fisiologia , Disfunção Cognitiva/sangueRESUMO
BACKGROUND: The purpose of this study was to compare the efficacy and safety of Ultra-mini-percutaneous nephrolithotomy (UMP) and Retrograde intrarenal surgery (RIRS) for renal/upper ureteral calculi in 1.0-2.0 cm diameter. METHODS: From October 2017 to October 2022, the surgical treatment of patients with renal/upper ureteral calculi in 1.0-2.0 cm diameter who were admitted to our hospital was retrospectively analyzed. They were divided into two groups, the UMP group (sixty-two cases) and the RIRS group (one hundred and nine cases), according to the different surgical methods. Baseline data includes general information, stone size, location, CT value, hydronephrosis, creatinine level, etc. RESULTS: Intraoperative blood loss was 33.6 ± 8.5 ml in the UMP group was significantly more than 4.3 ± 0.7 ml in the RIRS group (P < 0.05). Intraoperative renal pelvis pressure of UMP group 10.5 ± 1.3 mmHg was significantly lower than RIRS group 23.6 ± 5.6 mmHg (P < 0.05). The incidence of postoperative infection was higher in the RIRS group (thirteen cases [11.93%]), and one case ([1.61%]) in the UMP group (P < 0.05). Routine CT scans on the second day and two months after surgery showed that the stone clearance rates in the UMP group were 87.1% and 93.5%, respectively, higher than those in the RIRS group (69.7% and 79.8%, respectively; P < 0.05). CONCLUSION: UMP has the advantage of a higher stone-free rate but a higher risk of injury and bleeding. The advantages of RIRS include less trauma, less bleeding, and faster recovery, but lower stone-free rates and a higher risk of infection.
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Cálculos Renais , Nefrolitotomia Percutânea , Cálculos Ureterais , Humanos , Masculino , Feminino , Cálculos Ureterais/cirurgia , Estudos Retrospectivos , Pessoa de Meia-Idade , Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Adulto , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , IdosoRESUMO
OBJECTIVE: Following tonsillectomy, postoperative pain and hemorrhage from the tonsillar bed are causes of significant morbidity. Intracapsular tonsillectomy with Coblation is suggested to minimize such morbidity while remaining efficacious in long-term outcomes. This systematic review and meta-analysis assessed short-term morbidity and long-term outcomes from intracapsular tonsillectomy with Coblation, focusing primarily on posttonsillectomy hemorrhage. DATA SOURCES: Medline, Embase, and the Cochrane Library. REVIEW METHODS: Guided by PRISMA guidelines, studies on intracapsular tonsillectomy with Coblation published between December 2002 and July 2022 evaluating frequency of posttonsillectomy hemorrhage were screened. Studies without primary data were excluded. Meta-analysis was conducted using the random-effect model. The primary outcome was the proportion of patients who experienced posttonsillectomy hemorrhage. The secondary outcomes were posttonsillectomy pain, the proportion requiring revision tonsillectomy, and severity of sleep-disordered breathing measured by polysomnography outcomes. RESULTS: From 14 studies there were 9821 patients. The proportion of total posttonsillectomy hemorrhage was 1.0% (95% confidence interval [CI] 0.5%-1.6%, n = 9821). The proportion experiencing primary hemorrhage, secondary hemorrhage, and those requiring further tonsil surgery were 0.1% (95% CI 0.0%-0.1%; study n = 7), 0.8% (95% CI 0.2%-1.4%; study n = 7), and 1.4% (95% CI 0.6%-2.2%; study n = 6), respectively. Mean reduction in apnea-hypopnea index was -16.0 events per hour (95% CI -8.8 to -23.3, study n = 3) and mean increase in oxygen nadir was 5.9% (95% CI 2.6%-9.1%, study n = 3). CONCLUSION: Intracapsular tonsillectomy with Coblation has been demonstrated to have a low rate of posttonsillectomy hemorrhage. Data regarding long-term tonsil regrowth and need for reoperation were encouraging of the efficacy of this technique.
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Tonsilectomia , Humanos , Dor Pós-Operatória , Tonsila Palatina/cirurgia , Hemorragia Pós-Operatória/etiologia , Síndromes da Apneia do Sono/cirurgia , Tonsilectomia/métodosRESUMO
BACKGROUND: The impact of atrial fibrillation (AF) on the clinical outcomes in patients with acute ischemic stroke (AIS) who received endovascular thrombectomy remains unclear. We aimed to perform a meta-analysis of adjusted effect estimates to examine the association between the presence of AF and the clinical outcomes in patients with AIS who received endovascular thrombectomy. METHODS AND RESULTS: We searched PubMed, Embase, and the Cochrane database between January 1, 2013 and July 10, 2023. Data were meta-analyzed to compare the outcomes among patients with AIS with and without AF who received endovascular thrombectomy. Our primary outcome was 90-day functional independence defined as a modified Rankin Scale score of 0 to 2. Secondary outcomes included excellent independence (90-day modified Rankin Scale score of 0-1), 90-day mortality, symptomatic intracranial hemorrhage, and any intracranial hemorrhage. Eighteen observational studies comprising 16 096 patients with AIS (mean age, 70.1 years; women, 48.2%; 6862 with AF versus 9234 without AF) were included. There were no statistically significant differences for modified Rankin Scale score of 0 to 2 (pooled odds ratio [OR], 1.14 [95% CI, 0.95-1.37]; [95% prediction interval [PI], 0.72-1.80]), mortality (OR, 0.92 [95% CI, 0.79-1.08]; [95% PI, 0.77-1.11]), symptomatic intracranial hemorrhage (OR, 0.97 [95% CI, 0.71-1.32]; [95% PI, 0.43-2.17]), and any intracranial hemorrhage (OR, 1.08 [95% CI, 0.91-1.28]; [95% PI, 0.74-1.58]) among patients with AIS with and without AF. CONCLUSIONS: This meta-analysis detected no significant differences in 90-day functional outcomes, mortality, and intracerebral hemorrhage risk after endovascular thrombectomy in patients with AIS with and without AF. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero; Unique identifier: CRD 42021293511.
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Fibrilação Atrial , Isquemia Encefálica , Procedimentos Endovasculares , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Acidente Vascular Cerebral/etiologia , AVC Isquêmico/cirurgia , AVC Isquêmico/etiologia , Isquemia Encefálica/etiologia , Fibrilação Atrial/cirurgia , Fibrilação Atrial/etiologia , Resultado do Tratamento , Trombectomia/efeitos adversos , Trombectomia/métodos , Hemorragias Intracranianas/epidemiologia , Hemorragias Intracranianas/etiologia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/métodosRESUMO
Since tyrosine kinase inhibitor (TKI) could reverse ABCG2-mediated drug-resistance, novel chlorin e6-based conjugates of Dasatinib and Imatinib as photosensitizer (PS) were designed and synthesized. The results demonstrated that conjugate 10b showed strongest phototoxicity against HepG2 and B16-F10 cells, which was more phototoxic than chlorin e6 and Talaporfin. It could reduce efflux of intracellular PS by inhibiting ABCG2 in HepG2 cells, and localize in mitochondria, lysosomes, golgi and ER, resulting in higher cell apoptosis rate and ROS production than Talaporfin. Moreover, it could induce cell autophagy and block cell cycle in S phase, and significantly inhibit tumor growth and prolong survival time on BALB/c nude mice bearing HepG2 xenograft tumor to a greater extent than chlorin e6. Consequently, compound 10b could be applied as a promising candidate PS due to its good water-solubility and stability, low drug-resistance, high quantum yield of 1O2 and excellent antitumor efficacy in vitro and in vivo.
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Fotoquimioterapia , Porfirinas , Animais , Camundongos , Humanos , Fármacos Fotossensibilizantes , Camundongos Nus , Linhagem Celular Tumoral , Fotoquimioterapia/métodos , Porfirinas/farmacologiaRESUMO
Background: An unprecedented coronavirus disease 2019 (COVID-19) wave occurred in China between December 2022 and January 2023, challenging the efficacy of the primary series of COVID-19 vaccines. The attitudes toward future COVID-19 booster vaccines (CBV) after the massive breakthrough infection among healthcare workers remain unknown. This study aimed to explore the prevalence and determinants of future CBV refusal after the unprecedented COVID-19 wave among healthcare workers. Methods: Between 9 and 19 February 2023, a cross-sectional nationwide online survey was conducted using a self-administered questionnaire vaccine among healthcare workers in China. Sociodemographics, profession, presence of chronic medical conditions, previous COVID-19 infection, attitudes towards future CBV, and reasons for future CBV refusal were collected. We estimated odds ratio [OR] with 95% confidence interval [CI] using a multivariable logistic regression model to explore the factors associated with future CBV refusal. Results: Among the 1618 participants who completed the survey, 1511 respondents with two or more doses of COVID-19 vaccines were analyzed. A total of 648 (41.8%) of respondents were unwilling to receive a future CBV. Multivariable logistic regression analysis revealed the association of CBV refusal with profession (vs. other staff, physician-adjusted OR 1.17, 95%CI 0.79-1.72, nurse-adjusted OR 1.88, 95%CI 1.24-2.85, p = 0.008), history of allergy (adjusted OR 1.72, 95%CI 1.05-2.83, p = 0.032), a lower self-perceived risk of future COVID-19 infection (p < 0.001), and a lower belief in CBV effectiveness (p = 0.014), safety (p < 0.001), and necessities for healthcare workers and the public (p < 0.001, respectively). Conclusions: Our findings highlight that a considerable proportion of healthcare workers were against a future booster dose after an unprecedented COVID-19 wave. Self-perception of future COVID-19 risk, and potential harm or doubtful efficacy of vaccines are the main determinants. Our findings may help public health authorities to establish future COVID-19 vaccination programs.
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Perillae Fructus oil has an important function in relieving cold stress. However, its application in this aspect has still been restricted because of instability and low bioavailability. In this study, Perillae Fructus oil was extracted through Soxhlet extraction, analyzed through gas chromatography-mass spectrometry (GC-MS), and nanopackaged into a yeast shell for the preparation of nanoparticles for oral administration. The characteristics of the nanoparticles were investigated using a Malvern zeta-size nanoinstrument, scanning electron microscopy (SEM), and high-performance liquid chromatography (HPLC). Then, the roles of orally administered nanoparticles in relieving cold stress were evaluated by investigating blood physiological and biochemical indexes in mice. The results showed that the oil yield from Perillae Fructus and shell yield from yeast cells were ~48.37% and ~16.87%, respectively. Approximately 89.21% of the added oil was packaged into the yeast shell to form nanoparticles with an average diameter of 316.74 nm and a surface charge of +2.9 mV. The nanoparticles were stable in simulated gastric acid and could be effectively released in simulated intestinal fluid with an efficiency of ~91.34%. After oral administration of nanoparticles, the mouse blood indexes of white blood cells (WBCs), superoxide dismutase (SOD) activity, and malonaldehyde (MDA) content were recovered compared to those in model mice, with a more remarkable effect than oral administration of free Perillae Fructus oil. Overall, the stability and bioavailability were improved by packaging Perillae Fructus oil into a yeast shell. These nanoparticles are a new agent for the prevention of cold stress.
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BACKGROUND AND PURPOSE: Chinese mind-body exercise-Baduanjin has received increasing attention for health promotion among middle-aged and older adults in China, but there is a lack of high-quality evidence on its effectiveness. This systematic review and meta-analysis was conducted to investigate the effects of Baduanjin on physical function in middle-aged and older adults. METHODS: Seven electronic databases were searched for articles published before 22 June 2021 with the keywords Baduanjin exercise combined with physical-function-related outcomes. Risk of bias was assessed in the included studies, and data were analyzed using Review Manager software V5.3. RESULTS: Fifteen articles, including 14 randomized controlled trials, were included in this study. The results of the meta-analysis showed that Baduanjin significantly improved muscle strength (grip strength: SMD = 0.63, 95% CI 0.22 to 1.04, p = 0.003), balance ability (timed up-and-go test score: MD = -2.21, 95% CI -3.91 to -0.51, p = 0.01; one-leg stand test score: MD = 3.75, 95% CI 1.96 to 5.55, p < 0.0001; Berg balance scale score: MD = 4.16, 95% CI 2.49 to 5.83, p < 0.00001; strengthening Romberg's test result: SMD = 1.02, 95% CI 0.17 to 1.86, p = 0.02); and cardiorespiratory fitness (diastolic blood pressure: MD = -3.62, 95% CI -3.95 to -3.30, p < 0.00001; resting heart rate: MD = -1.30, 95% CI -1.57 to -1.03, p < 0.00001; step test: MD = 4.25, 95% CI 0.76 to 7.74, p = 0.02). No adverse events were reported. CONCLUSIONS: Baduanjin exercise may be an effective intervention to improve physical function in the middle-aged and elderly population. However, more RCTs with larger sample sizes and more rigorous research designs are needed in the future to confirm the results.
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Exercício Físico , Qualidade de Vida , Pessoa de Meia-Idade , Humanos , Idoso , Ensaios Clínicos Controlados Aleatórios como Assunto , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Força Muscular/fisiologiaRESUMO
Background: Whether low-dose alteplase is similar to standard-dose bridging alteplase prior to endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS) remains uncertain. Aims: The aim of this study was to compare the efficacy and safety outcomes of low- versus standard-dose bridging alteplase therapy (BT) in patients with acute ischemic stroke (AIS) who are eligible for intravenous thrombolysis (IVT) within 4.5 h after onset. Methods: We conducted an indirect comparison of low- versus standard-dose bridging alteplase before mechanical thrombectomy in AIS of current available clinical randomized controlled trials (RCTs) that compared direct mechanical thrombectomy treatment (dMT) to BT. Primary efficacy outcomes were functional independence and excellent recovery defined as a dichotomized modified Rankin Scale (mRS) 0-2 and 0-1 at 90 days. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and any intracranial hemorrhage (ICH). Results: We included six RCTs of 2334 AIS patients in this analysis, including one trial using low-dose bridging alteplase (n = 103) and five trials using standard-dose bridging alteplase (n = 1067) against a common comparator (dMT). Indirect comparisons of low- to standard-dose bridging alteplase yielded an odds ratio (OR) of 0.84 (95% CI 0.47-1.50) for 90-day mRS 0-2, 1.18 (95% CI 0.65-2.12) for 90-day mRS 0-1, 1.21 (95% CI 0.44-3.36) for mortality, and 1.11 (95% CI 0.39-3.14) for successful recanalization. There were no significant differences in the odds for sICH (OR 1.05, 95% CI 0.32-3.41) or any ICH (OR 1.71, 95% CI 0.94-3.10) between low- and standard-dose bridging alteplase. Conclusion: Indirect evidence shows that the effects of low- and standard-dose bridging alteplase are similar for key efficacy and safety outcomes. Due to the wide confidence intervals, larger randomized trials comparing low- and standard-dose alteplase bridging therapy are required.
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Soil microorganisms play an important role in the biogeochemical cycles of terrestrial ecosystems. How-ever, it is still unclear how the amount and duration of nitrogen (N) addition affect soil microbial community structure and whether there is a correlation between the changes in microbial community structure and their nutrient limi-tation status. In this study, we conducted an N addition experiment in a subtropical Pinus taiwanensis forest to simulate N deposition with three treatments: control (CK, 0 kg N·hm-2·a-1), low N (LN, 40 kg N·hm-2·a-1), and high N (HN, 80 kg N·hm-2·a-1). Basic soil physicochemical properties, phospholipid fatty acids content, and carbon (C), N and phosphorus (P) acquisition enzyme activities were measured after one and three years of N addition. The relative nutrient limitation status of soil microorganisms was analyzed using ecological enzyme stoichiometry. The results showed that one-year N addition did not affect soil microbial community structure. Three-year LN treatment significantly increased the contents of Gram-positive bacteria (G+), Gram-negative bacteria (G-), actinomycetes (ACT), and total phospholipid fatty acids (TPLFA), whereas three-year HN treatment did not significantly affect soil microbial community, indicating that bacteria and ACT might be more sensitive to N addition. Nitrogen addition exacerbated soil C and P limitation. Phosphorus limitation was the optimal explanatory factor for the changes in soil microbial community structure. It suggested that P limitation induced by N addition might be more beneficial for the growth of certain oligotrophic bacteria (e.g. G+) and the microorganisms participating in the P cycling (e.g. ACT), with consequences on soil microbial community structure of subtropical Pinus taiwanensis forest.
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Microbiota , Pinus , Fósforo , Nitrogênio/análise , Solo/química , Biomassa , Microbiologia do Solo , Florestas , Fosfolipídeos , Ácidos Graxos , Bactérias , Carbono , ChinaRESUMO
Objectives: Regular Baduanjin exercise training has been shown to be beneficial to the physical and cognitive health of older adults, but the underlying mechanisms remain to be investigated. This study examined the influence of Baduanjin on cerebral hemodynamics in community-dwelling older adults with cognitive frailty. Design: Randomized controlled trial. Methods: A total of 102 eligible participants were randomly allocated into the Baduanjin exercise intervention group (BEG) or usual physical activity control group (CG) for 24 weeks. Cerebral hemodynamic parameters of bilateral middle/anterior cerebral artery and basilar artery, cognitive ability and physical frailty were assessed using Transcranial Doppler (TCD), Montreal Cognitive Assessment (MoCA) and Edmonton Frailty Scale (EFS) at baseline and 24 weeks post-intervention. Results: After 24 weeks intervention, the changes in peak systolic velocity (PSV), mean blood flow velocity (MBFV), and end diastolic velocity (EDV) in the right middle cerebral artery and basilar artery were better in the BEG than in the CG; the increase in MoCA scores and the decrease in EFS scores were significantly higher in the BEG than in the CG. Moreover, the interaction of exercise and time on those variables showed obvious significance. Conclusions: The 24 weeks Baduanjin exercise training had a positive beneficial effect on cerebral blood flow in community-dwelling older adults with cognitive frailty. This may be a potential mechanism by which Baduanjin exercise improves the cognitive frailty in older adults. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800020341. Date of registration: December 25, 2018, http://www.chictr.org.cn/showproj.aspx?proj=29846.
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OBJECTIVE: To determine the effect of a 6-month traditional Chinese mind-body Baduanjin exercise intervention on cognitive ability in older people with Mild cognitive impairment (MCI). METHODS: A total of 135 community-dwelling seniors with MCI were randomized into either the Baduanjin group (BDJ), the brisk walking group (BWK) or the usual physical activity control group (UPA). Cognitive ability was assessed at baseline, 2, 4 and 6 months post-intervention, and 3 months after the intervention ended. RESULTS: After 6 months of intervention, the MoCA score of the BDJ group was significantly higher than that of the UPA group (P < 0.05), The Go/No-go correct numbers of the BDJ group and BWK group were significantly higher than those of the UPA group (P < 0.05). There was no statistical difference in other outcomes, or there were only a tiny effect size. Three months after the intervention, there was no significant difference between the primary and secondary outcomes(P > 0.05). CONCLUSION: The 6-month period of Baduanjin training has positive benefits on global cognitive function and attention function in community-dwelling elderly individuals with MCI. The effect seems to have been transient and needs to be confirmed by additional studies.
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Disfunção Cognitiva , Vida Independente , Humanos , Idoso , Terapia por Exercício , Cognição , Disfunção Cognitiva/terapia , Disfunção Cognitiva/psicologia , Exercício Físico/psicologiaRESUMO
Priming effect (PE) plays an important role in regulating terrestrial soil carbon (C) cycling, but the impact of different C addition modes on the PE in subtropical forest ecosystems with increasing nitrogen (N) deposition is unclear. In this study, we investigated the effects of C addition patterns (single or repeated C addition) on soil PE by adding 13C-labeled glucose for 90 d in an incubation experiment with different levels of N application (0, 20, and 80 kg N·hm-2·a-1). The different patterns of glucose addition significantly increased soil organic C (SOC) mineralization and produced positive PE. Single glucose addition resulted in stronger PE than repeated addition. PE was significantly weakened with increasing N application levels, indicating that N deposition inhibited soil excitation in Phyllostachys edulis forests. The cumulative PE was significantly negatively correlated with ß-N-acetylaminoglucosidase (NAG) and peroxidase (PEO) activities, and was significantly positively correlated with microbial biomass P (MBP) and potential of hydrogen (pH). Our findings indicated that, when acting together on soil, N application and C addition could strongly affect soil C stocks by stimulating the mineralization of native soil organic matter in subtropical forests. The findings further indicated that single C addition model might overestimate the effect of exogenous readily decomposable organic C on PE and ignore the effect of N deposition on PE, which in turn would overestimate the mineralization loss of forest SOC.
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Carbono , Solo , Nitrogênio/farmacologia , Ecossistema , Florestas , Poaceae , GlucoseRESUMO
After kidney transplantation, patients exhibit a poor response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. However, the efficacy and adverse effects of vaccines based on different platforms in these patients remain unclear. We prospectively analyzed both anti-spike protein antibody and cellular responses 1 month after the first and second doses of SARS-CoV-2 vaccines in 171 kidney transplant patients. Four vaccines, including one viral vector (ChAdOx1 nCov-19, n = 30), two mRNA (mRNA1273, n = 81 and BNT162b2, n = 38), and one protein subunit (MVC-COV1901, n = 22) vaccines were administered. Among the four vaccines, mRNA1273 elicited the strongest humoral response and induced the highest interferon-γ levels in patients with a positive cellular response against the spike protein. Antiproliferative agents were negatively associated with both the antibody and cellular responses. A transient elevation in creatinine levels was noted in approximately half of the patients after the first dose of mRNA1273 or ChadOx1, and only one of them presented with borderline cellular rejection without definite causality to vaccination. In conclusion, mRNA1273 had better immunogenicity than the other vaccines. Further, renal function needs to be carefully monitored after vaccination, and vaccination strategies should be tailored according to the transplant status and vaccine characteristics.
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Vacinas contra COVID-19 , COVID-19 , Transplante de Rim , Anticorpos Antivirais , Vacina BNT162 , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , ChAdOx1 nCoV-19 , Creatinina , Humanos , Interferon gama , Transplante de Rim/efeitos adversos , Subunidades Proteicas , RNA Mensageiro , SARS-CoV-2 , Transplantados , Vacinação , Vacinas ViraisRESUMO
Soil phosphatases are important in the mineralization of organophosphates and in the phosphorus (P) cycle. The kinetic mechanisms of phosphatases in response to nitrogen (N) deposition remain unclear. We carried out a field experiment with four different concentrations of N: 0 g N·hm-2·a-1(control), 20 g N·hm-2·a-1(low N), 40 g N·hm-2·a-1(medium N), and 80 g N·hm-2·a-1(high N) in a subtropical Moso bamboo forest. Soil samples were then collected from 0 to 15 cm depth, after 3, 5 and 7 years of N addition. We analyzed soil chemical properties and microbial biomass. Acid phosphatase (ACP) was investigated on the basis of maximum reaction velocity (Vm), Michaelis constant (Km), and catalytic efficiency (Ka). Results showed that N addition significantly decreased soil dissolved organic carbon (DOC), available phosphorus, and organophosphate content, but significantly increased soil ammonium, nitrate-N content, and Vm. There was a significant relationship between Vm and the concentrations of available phosphorus, organophosphate, and soil DOC. In general, N addition substantially increased Ka, but did not affect Km. The Km value in the high N treatment group was higher than that in the control group after five years of N addition. Km was significantly negatively associated with both available phosphorus and organophosphate. Medium and high N treatments had stronger effects on the kinetic parameters of ACP than low N treatment. Results of variation partition analysis showed that changes in soil chemical properties, rather than microbial biomass, dominated changes in Vm(47%) and Km(33%). In summary, N addition significantly affected substrate availability in Moso bamboo forest soil and modulated soil P cycle by regulating ACP kinetic parameters (especially Vm). The study would improve the understanding of the mechanisms underlying soil microorganisms-regulated soil P cycle under N enrichment. These mechanisms would identify the important parameters for improving soil P cycling models under global change scenarios.
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Nitrogênio , Solo , Fosfatase Ácida , Carbono/análise , China , Florestas , Nitrogênio/análise , Organofosfatos , Monoéster Fosfórico Hidrolases , Fósforo/análise , Poaceae , Solo/química , Microbiologia do SoloRESUMO
BACKGROUND: Living donor kidney transplantation (LDKT) is an important organ resource, especially in countries with low deceased donation rates. Strategies for expanding access to transplantation should be developed by identifying the modifiable factors. In this study, we evaluated these factors in the relatives of patients from both medical centers and dialysis clinics using questionnaires. METHODS: The questionnaires were anonymous and confidential. We collected questionnaires from previous donors, relatives of patients on the waitlist in the medical center, and relatives of dialysis patients in three nephrology clinics. The study groups were divided into three categories: donor group (n = 68), willing group (n = 43), and non-donor group (n = 65). RESULTS: Respondents in the clinics had lower cognition and willingness towards LDKT than those in the medical center. More knowledge of LDKT, better relationship with patients, more familial support, and female gender were positively related to donation. The non-donor group tended to want to maintain an intact body for the afterlife. There was no significant difference in age, educational degree, average monthly income, and medical compliance among the three groups. CONCLUSION: More efforts need to be made in dialysis clinics, where general nephrologists are important for the outreach of information. In addition, dealing with religious ambivalence and reestablishing cultural mindsets with health education programs are important issues in a non-Christian country.
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Transplante de Rim , Doadores Vivos , Feminino , Humanos , Rim , Diálise Renal , Inquéritos e QuestionáriosRESUMO
Understanding changes in soil enzyme activities and ecoenzymatic stoichiometry is important for assessing soil nutrient availability and microbial nutrient limitation in mountain ecosystems. However, the variations of soil microbial nutrient limitation across elevational gradients and its driving factors in subtropical mountain forests are still unclear. In this study, we measured soil properties, microbial biomass, and enzyme activities related to carbon (C), nitrogen (N), and phosphorus (P) cycling in Pinus taiwanensis forests at different altitudes of Wuyi Mountains. By analyzing the enzyme stoichiometric ratio, vector length (VL), and vector angle (VA), the relative energy and nutrient limitation of soil microorganisms and its key regulatory factors were explored. The results showed that ß-glucosaminidase (BG) activities increased along the elevational gradient, while the activities of ß-N-acetyl glucosaminidase (NAG), leucine aminopeptidase (LAP), acid phosphatase (AcP) and (NAG+LAP)/microbial biomass carbon (MBC) and AcP/MBC showed the opposite trend. Enzyme C/N, enzyme C/P, enzyme N/P, and VL were enhanced with increasing elevation, while VA decreased, indicating a higher degree of microbial P limitation at low elevation and higher C limitation at high elevation. In addition, our results suggested that dissolved organic carbon and microbial biomass phosphorus are critical factors affecting the relative energy and nutrient limitation of soil microorganisms at different elevations. The results would provide a theoretical basis for the responses of soil carbon, nitrogen, and phosphorus availability as well as the relative limitation of microbial energy and nutrition to elevational gradients, and improve our understanding of soil biogeochemical cycle process in subtropical montane forest ecosystems.
Assuntos
Pinus , Solo , Carbono/análise , China , Ecossistema , Florestas , Nitrogênio/análise , Fósforo/análise , Microbiologia do SoloRESUMO
Background: Regular Baduanjin exercise intervention was proven to be beneficial in improving the cognitive ability and physical performance of older adults with different health conditions but was unclear to influence the structural plasticity of the hippocampus. This study aimed to explore the modulation of hippocampal subregions as a mechanism by which Baduanjin exercise improves cognitive frailty in older adults. Methods: A total of 102 community-dwelling older adults with cognitive frailty were recruited and randomly allocated to the Baduanjin exercise training group and usual physical activity control group. The participants in the Baduanjin exercise training group participated in a 24-week Baduanjin exercise intervention program with an exercise frequency of 60 min per day, 3 days per week. Cognitive ability and physical frailty were assessed, and MRI scans were performed on all participants at baseline and after 24 weeks of intervention. The structural MRI data were processed with MRIConvert (version 2.0 Rev. 235) and FreeSurfer (version 6.0.0) software. Data analyses were performed using the independent sample t tests/Mann-Whitney U tests with the Bonferroni correction, mixed linear model, correlation, or mediation analysis by the SPSS 24.0 software (IBM Corp, Armonk, NY, United States). Results: After 24 weeks of intervention, a statistically significant increase was found for the Montreal Cognitive Assessment (MoCA) scores (p = 0.002) with a large effect size (Cohen's d = 0.94) and the significant interaction effect (P goup × time < 0.05), Memory Quotient (MQ) scores (p = 0.019) with a medium effect size (Cohen's d = 0.688) and the significant interaction effect (P goup × time < 0.05), and other parameters of WMS-RC test including pictures (p = 0.042), recognition (p = 0.017), and association (p = 0.045) test with a medium effect size (Cohens' d = 0.592, 0.703, and 0.581) for the Baduanjin training group, while significant decrease for the Edmonton Frailty Scale (EFS) score (p = 0.022), with a medium effect size (Cohen's d = -0.659) and the significant interaction effect (P goup × time < 0.05) for the Baduanjin training group. The differences in the left parasubiculum, Hippocampal Amygdala Transition Area (HATA), right Cornu Ammonis Subfield 1 (CA1) and presubiculum volumes from baseline to 24 weeks after intervention in the Baduanjin training group were significantly greater than those in the control group (p < 0.05/12). Further analysis showed that the changes in right CA1 volume were positively correlated with the changes in MoCA and MQ scores (r = 0.510, p = 0.015; r = 0.484, p = 0.022;), the changes in right presubiculum and left parasubiculum volumes were positively correlated with the changes in MQ (r = 0.435, p = 0.043) and picture test scores (r = 0.509, p = 0.016), respectively, and the changes in left parasubiculum and HATA volumes were negatively correlated with the changes in EFS scores (r = -0.534, p = 0.011; r = -0.575, p = 0.005) in the Baduanjin training group, even after adjusting for age, sex, years of education and marital status; furthermore, the volume changes in left parasubiculum and left HATA significantly mediated the Baduanjin exercise training-induced decrease in the EFS scores (ß = 0.376, 95% CI 0.024 ~ 0.947; ß = 0.484, 95% CI 0.091 ~ 0.995); the changes of left parasubiculum and right CA1 significantly mediated the Baduanjin exercise training-induced increase in the picture and MO scores (ß = -0.83, 95% CI-1.95 ~ -0.002; ß = -2.44, 95% CI-5.99 ~ -0.32). Conclusion: A 24-week Baduanjin exercise intervention effectively improved cognitive ability and reduced physical frailty in community-dwelling older adults with cognitive frailty, and the mechanism might be associated with modulating the structural plasticity of the hippocampal subregion.