Quality Evaluation of Guidelines for the Diagnosis and Treatment of Liver Failure.

OBJECTIVES: This study aimed to systematically assess the methodological quality and key recommendations of the guidelines for the diagnosis and treatment of liver failure (LF), furnishing constructive insights for guideline developers and equipping clinicians with evidence-based information to facilitate informed decision-making. DATA SOURCES: Electronic databases and manual searches from January 2011 to August 2023. STUDY SELECTION: Two reviewers independently screened titles and abstracts, then full texts for eligibility. Fourteen guidelines were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted data and checked by two others. Methodological quality of the guidelines was appraised using the Appraisal of Guidelines for Research and Evaluation II tool. Of the 14 guidelines, only the guidelines established by the Society of Critical Care Medicine and the American College of Gastroenterology (2023) achieved an aggregate quality score exceeding 60%, thereby meriting clinical recommendations. It emerged that there remains ample room for enhancement in the quality of the guidelines, particularly within the domains of stakeholder engagement, rigor, and applicability. Furthermore, an in-depth scrutiny of common recommendations and supporting evidence drawn from the 10 adult LF guidelines unveiled several key issues: controversy exists in the recommendation, the absence of supporting evidence and confusing use of evidence for recommendations, and a preference in evidence selection. CONCLUSIONS: There are high differences in methodological quality and recommendations among LF guidelines. Improving these existing problems and controversies will benefit existing clinical practice and will be an effective way for developers to upgrade the guidelines.

[Quantitative evaluation of lumbar spine osteoporosis by apparent diffusion coefficient and signal intensity ratio of magnetic resonance diffusion-weighted magnetic resonance imaging].

OBJECTIVE: To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis. METHODS: A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L2-L4 were measured and compared among the three groups and the correlation between ADC, SIR and BMD was analyzed. The ROC curve was used to evaluate the differential diagnosis value of ADC and SIR for osteoporosis, osteopenia and normal bone mass. RESULTS: There were statistically significant differences in ADC and SIR values among three groups (F=41.386, 37.114, all P=0.000). The ADC value of the osteoporosis group was lower than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (t=3.540, 9.069, P=0.001, 0.000);the SIR value of the osteoporosis group was higher than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (t=5.083, 8.523, all P=0.000). Spearman correlation analysis showed that ADC value was positively correlated with BMD (r=0.313, P=0.004);SIR value was negatively correlated with BMD (r=- 0.589, P=0.000). Receiver operator characteristic (ROC) curve analysis showed that the area under curve (AUC), sensitivity andspecificity of ADC and SIR in the diagnosis of lumbar osteoporosis and osteopenia were 0.742, 89.1% , 52.8% and 0.729, 89.1%, 50.9% respectively (P=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis and normal bone mass were 0.815, 100.0%, 50.0% and 0.856, 65.6%, 93.1%, respectively (P=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis were 0.78, 89.1%, 51.4% and 0.795, 50.0% and 94.6% respectively (P=0.000);All have a certain diagnostic value. CONCLUSION: ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.

Co-Modification of commercial TiO2 anode by combining a solid electrolyte with pitch-derived carbon to boost cyclability and rate capabilities.

The bad electrochemical performance circumscribes the application of commercial TiO2 (c-TiO2) anodes in Li-ion batteries. Carbon coating could ameliorate the electronic conductivity of TiO2, but the ionic conductivity is still inferior. Herein, a co-modification method was proposed by combining the solid electrolyte of lithium magnesium silicate (LMS) with pitch-derived carbon to concurrently meliorate the electronic and ionic conductivities of c-TiO2. The homogeneous mixtures were heated at 750 °C, and the co-modified product with suitable amounts of LMS and carbon demonstrates cycling capacities of 256.8, 220.4, 195.9, 176.4, and 152.0 mA h g-1 with multiplying current density from 100 to 1600 mA g-1. Even after 1000 cycles at 500 mA g-1, the maintained reversible capacity was 244.8 mA h g-1. The superior rate performance and cyclability correlate closely with the uniform thin N-doped carbon layers on the surface of c-TiO2 particles to favor the electrical conduction, and with the ion channels in LMS as well as the cation exchangeability of LMS to facilitate the Li+ transfer between the electrolyte, carbon layers, and TiO2 particles. The marginal amount of fluoride in LMS also contributes to the excellent cycling stability of the co-modified c-TiO2.

A uniform few-layered carbon coating derived from self-assembled carboxylate monolayers capable of promoting the rate properties and durability of commercial TiO2.

The poor cyclability and rate property of commercial TiO2 (c-TiO2) hinder its utilization in lithium-ion batteries (LIBs). Coating carbon is one of the ways to ameliorate the electrochemical performance. However, how to effectively form a uniform thin carbon coating is still a challenge. On the basis of the strong interaction of the TiO2 surface with carboxyl groups, herein a new tactic to achieve uniform and thin carbon layers on the c-TiO2 particles was proposed. When mixing c-TiO2 with citric acid containing carboxyl groups in deionized water, the high-affinity adsorption of TiO2 for carboxyl groups resulted in self-assembled carboxylate monolayers on the surface of TiO2 which evolved into a uniform few-layered amorphous carbon coating during carbonizing at 750 °C. The product derived from the mixture of c-TiO2 and citric acid with a mass ratio of 1 : 0.3 exhibits the optimal performance, revealing a high specific capacity (256.6 mA h g-1 after 50 cycles at 0.1 A g-1) and outstanding cycling stability (retaining a capacity of 160.0 mA h g-1 after 1000 cycles at 0.5 A g-1). The greatly enhanced capacity and cyclability correlate with the uniform few-layered carbon coating which not only ameliorates the electronic conductivity of c-TiO2 but also avoids the reduction in ionic conductivity caused by thick carbon layers and redundant carbon.

Combined Modification of Dual-Phase Li4Ti5O12-TiO2 by Lithium Zirconates to Optimize Rate Capabilities and Cyclability.

The low electrical conductivity and ordinary lithium-ion transfer capability of Li4Ti5O12 restrict its application to some degree. In this work, dual-phase Li4Ti5O12-TiO2 (LTOT) was modified by composite zirconates of Li2ZrO3, Li6Zr2O7 (LZO) to boost the rate capabilities and cyclability. When the homogeneous mixture of LiNO3, Zr(NO3)4·5H2O and LTOT was roasted at 700 °C for 5 h, the obtained composite achieved a superior reversible capacity of 183.2 mAh g-1 to the pure Li4Ti5O12 after cycling at 100 mA g-1 for 100 times due to the existence of a scrap of TiO2. Meanwhile, when the composite was cycled by consecutively doubling the current density between 100 and 1600 mA g-1, the corresponding reversible capacities are 183.2, 179.1, 176.5, 173.3, and 169.3 mAh g-1, signifying the prominent rate capabilities. Even undergoing 1400 charge/discharge cycles at 500 mA g-1, a reversible capacity of 144.7 mAh g-1 was still attained, denoting splendid cyclability. From a series of comparative experiments and systematic characterizations, the formation of LZO meliorated both the Li+ migration kinetics and electrical conductivity on account of the concomitant superficial Zr4+ doping, responsible for the comprehensive elevation of the electrochemical performance.

Apolipoprotein A5 gene polymorphisms are associated with non-alcoholic fatty liver disease.

BACKGROUND: Several studies have reported that apolipoprotein A5 (APOA5) is involved in the development of non-alcoholic fatty liver disease (NAFLD). However, no research has been performed regarding the association between APOA5 polymorphisms and the risk of NAFLD. This study aimed to explore the association between APOA5 gene polymorphisms and NAFLD in a Chinese Han population. METHODS: Genotypes of the SNPs (rs10750097, rs1263173, rs17120035, rs3135507 and rs662799) of APOA5 in 232 NAFLD patients and 188 healthy controls were determined using polymerase chain reaction (PCR) analysis. Clinical characteristics were measured using biochemical methods. RESULTS: The five single nucleotide polymorphisms (SNPs) (rs10750097, rs1263173, rs17120035, rs3135507 and rs662799) of APOA5 showed no significant association with NAFLD (P > 0.05). The rs10750097 with G allele showed a higher serum level of alkaline phosphatase (ALP) compared with C allele in overall series and NAFLD patients (P < 0.05). The rs1263173(A/A) carriers showed a higher level of glucose compared to the non-carriers in overall series (P < 0.05). The rs17120035(T/T) carriers showed a lower plasma TG level in overall series and NAFLD patients (P < 0.05), and the rs662799(G/G) carriers showed higher levels of plasma triglyceride (TG), ALP, and lower level of high-density lipoprotein (HDL) compared to non-carriers in NAFLD patients (P < 0.05). No significant difference were observed on the clinic parameters of APOA5 rs3135507(T/T) carriers in both group of overall series and NAFLD patients (P > 0.05). CONCLUSIONS: The five SNPs (rs10750097, rs1263173, rs17120035, rs3135507 and rs662799) of APOA5 gene are not associated with the risk of NAFLD in the Chinese Han population. The genotypes of rs10750097(G/G), rs1263173(A/A), rs17120035(T/T), and rs662799(G/G) performed a significant effect on clinic characteristics in overall series and NAFLD patients, indicating that these polymorphisms may be associated with NAFLD.

Uniform Surface Modification of Li2ZnTi3O8 by Liquated Na2MoO4 To Boost Electrochemical Performance.

Poor ionic and electronic conductivities are the key issues to affect the electrochemical performance of Li2ZnTi3O8 (LZTO). In view of the water solubility, low melting point, good electrical conductivity, and wettability to LZTO, Na2MoO4 (NMO) was first selected to modify LZTO via simply mixing LZTO in NMO water solution followed by calcining the dried mixture at 750 °C for 5 h. The electrochemical performance of LZTO could be enhanced by adjusting the content of NMO, and the modified LZTO with 2 wt % NMO exhibited the most excellent rate capabilities (achieving lithiation capacities of 225.1, 207.2, 187.1, and 161.3 mAh g-1 at 200, 400, 800, and 1600 mA g-1, respectively) as well as outstanding long-term cycling stability (delivering a lithiation capacity of 229.0 mAh g-1 for 400 cycles at 500 mA g-1). Structure and composition characterizations together with electrochemical impedance spectra analysis demonstrate that the molten NMO at the sintering temperature of 750 °C is beneficial to diffuse into the LZTO lattices near the surface of LZTO particles to yield uniform modification layer, simultaneously ameliorating the electronic and ionic conductivities of LZTO, and thus is responsible for the enhanced electrochemical performance of LZTO. First-principles calculations further verify the substitution of Mo6+ for Zn2+ to realize doping in LZTO. The work provides a new route for designing uniform surface modification at low temperature, and the modification by NMO could be extended to other electrode materials to enhance the electrochemical performance.

Nitrogen-doped hollow carbon spheres with a wrinkled surface: their one-pot carbonization synthesis and supercapacitor properties.

Nitrogen-doped hollow carbon spheres with a wrinkled surface were rationally synthesized for the first time by using graphene oxide as a morphology controlling agent through direct pyrolysis of core-shell structured GO-resol@melamine formaldehyde composites, showing excellent rate performance towards supercapacitors, due to their unique structural and surface properties.

Simple preparation of carbon nanofibers with graphene layers perpendicular to the length direction and the excellent li-ion storage performance.

Sulfur-containing carbon nanofibers with the graphene layers approximately vertical to the fiber axis were prepared by a simple reaction between thiophene and sulfur at 550 °C in stainless steel autoclaves without using any templates. The formation mechanism was discussed briefly, and the potential application as anode material for lithium-ion batteries was tentatively investigated. The carbon nanofibers exhibit a stable reversible capacity of 676.8 mAh/g after cycling 50 times at 0.1 C, as well as the capacities of 623.5, 463.2, and 365.8 mAh/g at 0.1, 0.5, and 1.0 C, respectively. The excellent electrochemical performance could be attributed to the effect of sulfur. On one hand, sulfur could improve the reversible capacity of carbon materials due to its high theoretical capacity; on the other hand, sulfur could promote the formation of the unique carbon nanofibers with the graphene layers perpendicular to the axis direction, favorable to shortening the Li-ion diffusion path.

Medicinal compounds with antiepileptic/anticonvulsant activities.

OBJECTIVE: Epilepsy is a serious neural disease that affects around 50 million people all over the world. Although for the majority patients with epilepsy, seizures are well controlled by currently available antiepileptic drugs (AEDs), there are still >30% of patients suffered from medically refractory epilepsy and approximately 30-40% of all epileptic patients affected by numerous side effects and seizure resistance to the current AEDs. Therefore, many researchers try to develop novel approaches to treat epilepsy, for example, to discover new antiepileptic constituents from herbal medicines. Although there are already several reviews on phytotherapy in epilepsy, most of them placed emphasis on the plant crude extracts or their isolated fractions, not pure active compounds derived from herbal medicines. This article aims to review components in herbal medicines that have shown antiepileptic or anticonvulsant properties. METHODS: We searched online databases and identified articles using the preset searching syntax and inclusion criteria. The active medicinal compounds that have shown anticonvulsant or antiepileptic activity were included and classified according to structural types. RESULTS: We have reviewed herein the active constituents including alkaloids, flavonoids, terpenoids, saponins, and coumarins. The screening models, the seizures-inducing factors and response, the effective dose, the potential mechanisms, as well as the structure-activity relationships in some of these active components have also been discussed. SIGNIFICANCE: The in vitro and in vivo experimental data reviewed in this paper would supply the basic science evidence for research and development of novel AEDs from medicinal plants.

[Induction of dendritic cells with multidrug resistance from K562/MDR1 cells].

OBJECTIVE: To induce the differentiation of K562/MDR1 cells into dendritic cells (DC) with multidrug resistance property. METHODS: K562/MDR1 cells and K562 cells were cultured in the presence of GM-CSF and IL-4 to generate DC and matured by TNF-α. On d14 K562/MDR1-DC and K562-DC cells were harvested and the expressions of CD1a, CD83, CD80, CD86, HLA-ABC and HLA-DR were assessed by flow cytometry (FCM). The antigen presentation function of K562/MDR1-DC and K562-DC was determined by allogenic mixed lymphocyte reaction (Allo-MLR). The expression of P-glycoprotein and the intracellular accumulation of daunorubicin (DNR) were detected by FCM. The sensitivity of K562/MDR1-DC and K562-DC cell to vincristine, adriamycin was measured using MTT assay. RESULTS: Both K562/MDR1 and K562 cells were differentiated into dendritic cells in the presence of cytokine cocktails, showing the morphologic and immunophenotypic characteristics of DC. K562/MDR1-DC more markedly enhanced proliferation of allogeneic lymphocytes in MLR than K562-DC. High level expression of P-glycoprotein and efflux of DNR were demonstrated in K562/MDR1-DC. K562/MDR1-DC showed multidrug resistance property, with higher IC(50) to VCR and ADM than that of K562-DCs. CONCLUSION: K562/MDR1 cells can be differentiated into DC with the presence of cytokines, the induced K562/MDR1-DC cells express high level of P-glycoprotein and acquire the multidrug resistance property.

Up-regulated expression of peroxisome proliferator-activated receptor gamma in the hypothalamic-pituitary-adrenal axis of weaned pigs after Escherichia coli lipopolysaccharide challenge.

The expression of peroxisome proliferator-activated receptor gamma (PPARgamma) was investigated in the hypothalamic-pituitary-adrenal (HPA) axis of weaned pigs after injection with 100 microg/kg bodyweight Escherichia coli lipopolysaccharide (LPS) (n=6) and control pigs injected with sterile saline (n=6). LPS increased PPARgamma mRNA and protein expression in the hypothalamus (23.8 and 3.1-fold relative to controls, respectively), pituitary gland (9.2 and 2.0-fold, respectively) and adrenal gland (3.5 and 2.3-fold, respectively) (P<0.05). LPS also induced an increase in PPARgamma immunohistochemical staining in the hypothalamus (1.3-fold), adenohypophysis (1.3-fold), adrenal cortex (1.4-fold) and adrenal medulla (1.6-fold) (P<0.05). Concurrent with up-regulated expression of PPARgamma, LPS increased the concentrations of plasma corticotrophin-releasing hormone (2.1-fold) and adrenocorticotrophin (1.4-fold) (P<0.05). LPS also induced elevations of interleukin 6 and tumour necrosis factor alpha mRNA levels in the hypothalamus (4.0 and 3.2-fold, respectively), pituitary gland (20.7 and 5.1-fold, respectively) and adrenal gland (3.9 and 3.3-fold, respectively) (P<0.05). PPARgamma may play a role in the regulation of neuroendocrine responses associated with immunological stress in pigs.