Abstract To evaluate the liver stiffness measurement (LSM) of normal people before and after diet using real-time shear wave elastography (SWE), and to explore the effect of diet on liver elasticity. Fifty-four healthy volunteers were selected and 480 mL of a standard diet containing 391 kcal were administrated. The LSM before diet and at 30 minutes after diet was significantly higher than baseline LSM. The LSM at 60 minutes after diet was significantly higher than that before diet. The LSM at 120 minutes after diet was significantly less than that before diet. 75% of the volunteers reached the peak of liver stiffness at 30 minutes or 60 minutes after diet. The LSM increased by more than 20% in 31% subjects, increased by less than 20% in 48%, and remained or decreased in 21%. The blood flow volume of portal vein was 692.02 ± 130.69 mL/min before diet, and it reached the maximum value of 776.41 ± 151.45 mL/min at 30 min after diet. Diet could affect the Young’s modulus measurement of liver. In order to avoid the effect, it is suggested to use real-time shear wave elastic imaging to measure the Young's modulus of liver on an empty stomach.

ABSTRACT Purpose: Spontaneous intracerebral hemorrhage (ICH) is a major public health problem with a huge economic burden worldwide. Ulinastatin (UTI), a serine protease inhibitor, has been reported to be anti-inflammatory, immune regulation, and organ protection by reducing reactive oxygen species production, and inflammation. Necroptosis is a programmed cell death mechanism that plays a vital role in neuronal cell death after ICH. However, the neuroprotection of UTI in ICH has not been confirmed, and the potential mechanism is unclear. The present study aimed to investigate the neuroprotection and potential molecular mechanisms of UTI in ICH-induced EBI in a C57BL/6 mouse model. Methods: The neurological score, brain water content, neuroinflammatory cytokine levels, and neuronal damage were evaluated. The anti-inflammation effectiveness of UTI in ICH patients also was evaluated. Results: UTI treatment markedly increased the neurological score, alleviate the brain edema, decreased the inflammatory cytokine TNF-α, interleukin‑1β (IL‑1β), IL‑6, NF‑κB levels, and RIP1/RIP3, which indicated that UTI-mediated inhibition of neuroinflammation, and necroptosis alleviated neuronal damage after ICH. UTI also can decrease the inflammatory cytokine of ICH patients. The neuroprotective capacity of UTI is partly dependent on the MAPK/NF-κB signaling pathway. Conclusions: UTI improves neurological outcomes in mice and reduces neuronal death by protecting against neural neuroinflammation, and necroptosis.

Abstract Objective: The objective was to evaluate whether initiation of urate-lowering treatment (ULT) during an acute gout flare prolonged the current episode. Methods: A comprehensive search of MEDLINE and Web of Science databases was conducted from their inception to 15 March 2021. Five randomized controlled trials (RCTs) with 381 patients met the inclusion criteria. Standardized mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of ULT in acute gout. Results: There was no statistical difference in days to resolution (intent-to-treat analysis) (SMD, 0.68; 95% CI — 0.42 to 1.78; I2, 49%; p = 0.22), the pain visual analogue score (VAS) by day 10 (SMD, — 0.07; 95% CI — 0.30 to 0.16; I2, 0%; p = 0.53), C-reactive protein (CRP) from day 7 to 10 (SMD, — 1.14; 95% CI — 5.63 to 3.36; I2, 55%; p = 0.62), erythrocyte sedimentation rate (ESR) from day 7 to 10 (SMD, — 2.51; 95% CI — 5.46 to 0.45; I2, 0%; p = 0.10) and the recurrence of gout flares within 28-30 days (OR 0.78; 95% CI 0.29 to 2.09; I2, 0%; p = 0.62). Conclusion: Initiation of ULT during an acute gout flare did not prolong the duration of the flare. However, larger sample size studies are needed to confirm this finding. Trial registration number PROSPERO (CRD42021234581).

Abstract Objectives Diabetes has been strongly associated with periodontal diseases. The periodontal ligament (PDL) has an abundant extracellular matrix (ECM). Lysyl oxidases (LOXs) are closely associated with various diseases caused by abnormal ECM functions, however, the role of LOXs in periodontal diseases induced by diabetes remains unclear. Methodology In this study, 8-week-old Zucker diabetic fatty rats were used to establish a type 2 diabetes mellitus (T2DM) model. After 9 and 16 weeks, hematoxylin and eosin (H&E), Masson’s trichrome, and immunohistochemical staining were performed. Results After 9 weeks, loose collagen fibers were found in the interradicular area of the diabetic group, in opposition to the control group. There were no significant differences in LOX expression between the diabetic and control groups (p>0.05). However, after 16 weeks, the diabetic group presented a disordered arrangement of the PDL, showing decreased collagen content and significantly increased lysyl oxidase-like protein 3 (LOXL3) expression when compared with the control group (p<0.05). This suggests that LOXL3 plays a significant role in periodontal histopathological changes in diabetic rats. Conclusion Our study showed elevated LOXL3 expression in the PDL of diabetic rats after 16 weeks, suggesting that LOXL3 may be involved in the occurrence and development of periodontal histopathological changes in diabetic rats. LOXL3 could be further used as an indicator for the early diagnosis of diabetic periodontitis in T2DM patients in clinical settings.

ABSTRACT Purpose: To observe the mechanism of prepared Radix Rehmanniainon combined with Radix Astragali in treating osteoporosis. Methods: Osteoporosis rat model was established by bilateral ovariectomy combined with low-calcium diet feeding. Bone mineral density was measured by bone densitometer. Bone metabolism markers in serum were detected by enzyme linked immunosorbent assay (ELISA), bone tissue structure was observed by hematoxylin-eosin staining, and the effect of prepared Radix Rehmanniainon combined with Radix Astragali on PI3K-AKT signaling pathway was investigated by immunohistochemistry and reverse transcription polymerase chain reaction. Results: Compared with the model group, the bone tissue structure and imbalance of bone metabolism were improved, and the bone mineral density was significantly increased in the prepared Radix Rehmanniainon combined with Radix Astragali groups. After intervention with prepared Radix Rehmanniainon combined with Radix Astragali, the positive expression of PIK3CA and Akt1 in rat bone tissue was enhanced, and the expression levels of Akt1 mRNA were significantly increased. Conclusions: Prepared Radix Rehmanniainon combined with Radix Astragali may treat osteoporosis by activating PI3K/AKT pathway.

ABSTRACT Purpose To study effects of Rehmannia glutinosa polysaccharides (RGP) on bone tissue structure and skeletal muscle atrophy in rats with disuse. Methods A rat model of disuse osteoporosis combined with muscle atrophy was established by removing the bilateral ovaries of rats and fixing their hind limbs for a long time. Forty SD rats were administered intragastrically for 12 weeks. The bone histomorphometry parameters and the level of oxidative stress were measured. In addition, the changes of muscle atrophy F-box (MAFbx), muscle RING-finger protein-1 (MuRF1), forkhead box O1 (FOXO1) mRNA expression in skeletal muscle of rats were observed. Results RGP significantly increased the percentage of fluorescence perimeter and bone mineralization deposition rate of the second lumbar vertebrae of rats. It also significantly increased the wet weight ratio and muscle fiber cross-sectional area of the gastrocnemius muscle of rats. At the same time, RGP significantly increased the levels of super oxide dismutase (SOD) and catalase (CAT) in the skeletal muscle of rats, and reduced the content of malondialdehyde (MDA). Rehmannia glutinosa polysaccharides also significantly reduced the expression levels of FOXO1, MAFbx and MuRF1 mRNA in rat skeletal muscle. Conclusions RGP could improve the bone structure of osteoporotic rats. It could also improve muscle that atrophy may be related to the inhibition of FOXO1-mediated ubiquitin-proteasome pathway.

ABSTRACT This study, consisting of two independent experiments, was conducted to optimize presowing guava seed treatments and evaluate the optimized treatments in improving germination and seedling growth of guava under heat and osmotic stresses. In the first experiment, seeds of guava cultivar White Flesh Local I were soaked in water, gibberellic acid (GA3) (0.05 and 0.1%), hydrochloric acid (HCl) (5 and 10%) and sulfuric acid (H2SO4) (5 and 10%) for 24 and 48 h (for water and GA3), and 2 and 5 min (for HCl and H2SO4). Seed soaking (priming) with GA3 (0.1%, at 48 h) and HCl (10%, 2 min) were the most effective treatments to improve seed germination and early seed growth of guava and were used in the second experiment. In the second experiment, treated and untreated seeds were sown in plastic boxes between two layers of filter papers maintained at osmotic potentials of 0, -1.5 and -3 MPa. The germination boxes were incubated at optimal (25 °C) and higher (32 °C) temperatures. Germination was significantly suppressed at a higher temperature and with an increase in the osmotic potential. However, seed treatments with GA3 and HCl were effective to improve the germination and seedling growth of guava under both temperature and osmotic stresses. In conclusion, chemical and hormonal seed treatments may help improve the seed germination and seedling growth of guava under heat and osmotic stresses by modulation of antioxidant enzymes and leaf proline. Seed treatment with GA3 (0.1%, 48 h) was the most effective in this regard.

The etiology of polycystic ovary syndrome (PCOS) is complex and the pathogenesis is not fully understood. Some studies have shown that dysregulation of ovarian granulosa cells may be related to abnormal follicles and excessive androgen in women with PCOS. Our team has also confirmed the high expression status of H19 in PCOS patients in the early stage. However, the relationship between H19 and miR-19b in the development of PCOS is still unknown. Therefore, we used bioinformatics to predict the binding sites of human H19 and miR-19b, and of miR-19b and CTGF genes. After the silencing and overexpression of H19, real-time polymerase chain reaction (PCR) was used to detect the expressions of H19, miR-19b, and CTGF. Western blotting was used to detect CTGF protein. Proliferation of KGN cells after H19 silencing was detected by CCK8. Flow cytometry was used to detect the apoptosis of KGN cells after H19 silencing. After the overexpression of H19, it was found that the expression of miR-19b gene decreased and the expression of CTGF increased, whereas silencing of H19 did the opposite. In addition, H19 could promote cell proliferation and decrease cell apoptosis. Finally, luciferase reporter assays showed that the 3′-end sequences of lncRNA H19 and CTGF contained the binding site of miR-19b. In conclusion, our study indicated that lncRNA H19 acted as a ceRNA to bind to miR-19b via a “sponge” to regulate the effect of CTGF on KGN cells, which may play a vital role in PCOS.

RESUMO Contexto A educação médica assíncrona via web, em Ambientes de Aprendizagem Virtual (AVA), cresceu muito, em virtude de suas diversas vantagens. Há várias configurações e métodos de instrução disponíveis. As propostas existentes são pouco estruturadas e/ou não são efetivamente utilizadas para o ensino de habilidades de diagnóstico para estudantes de graduação em Medicina, no Brasil. É necessário um método instrutivo robusto, com características pedagógicas positivas. Assim, propomos um método pedagogicamente estruturado para AVA, que inclui uma leitura inicial motivadora (Crônica Médica – CM) e um programa de construção de conhecimento, utilizando casos reais juntamente com recursos audiovisuais (Oficina Diagnóstica – OD). Objetivamos verificar a aceitação e a eficácia do método proposto na melhoria da capacidade diagnóstica dos estudantes de Medicina, em longo prazo. Métodos Foi desenvolvido um questionário de opiniões, dois materiais CM/OD e dois questionários de Conhecimento e Habilidades Diagnósticas (CHD) sobre acidente vascular encefálico e epilepsia. Dois grupos de estudantes de Medicina foram acompanhados neste estudo observacional longitudinal, em 2013. Os alunos responderam ao CHD1 e participaram de uma aula teórica tradicional, sobre um dos tópicos. Eles também acessaram um AVA para realizar o método CM/OD sobre um dos dois temas. O mesmo questionário (CHD2 e CHD3) foi aplicado, respectivamente, um mês e cinco-seis meses após o CHD1. Analisamos a média CHD1 de todos os alunos e as médias pareadas nos três momentos, dos que acessaram e daqueles que não acessaram o AVA. O questionário de opiniões foi aplicado e analisado por estatística descritiva. Resultados Oitenta e sete alunos participaram, mas seis foram excluídos por não responderem a todos os questionários. A média geral do CHD1 foi de 1,59 (desvio-padrão 0,71). Dos 81 participantes, 66 (81,5%) acessaram o AVA, mostrando melhora significativa nas habilidades de diagnóstico no CHD2 (média 5,65, p <0,05) e CHD3 (média 4,57, p < 0,05), com variações não significativas para aqueles que não acessaram. A CM foi considerada pelo menos boa para 62 alunos (94%), e 52 alunos (78,8%) julgaram que o gabarito disponível foi suficiente para sanar todas as dúvidas da OD. Conclusões O método CM/OD no AVA provou ser eficaz para melhorar a capacidade de diagnóstico dos estudantes de graduação em Medicina, em longo prazo, e foi bem aceito pelos alunos. Ele apresenta várias características pedagógicas positivas e pode ser replicado.

ABSTRACT Background Asynchronous Web-based Medical Education in Virtual Learning Environments (VLEs) has grown steadily because of its many advantages. Various configurations and instructional methods are presently available. The existing proposals are poorly structured and/or not very effectively used for teaching diagnostic skills to undergraduate medical students in Brazil. A robust instructional method with positive pedagogical characteristics is needed. Thus, we have proposed a pedagogically-structured method for VLEs that includes a motivating initial reading (Medical Chronicle – MC), and a knowledge building program, using real cases coupled with audiovisual resources (Diagnostic Workshop – DW). We aimed to verify its acceptance, as well as the efficacy of the MC/DW method in improving the diagnostic ability of medical students, in the long term. Methods An opinion survey, two MC/DW materials and two Knowledge and Diagnostic Skills (KDS) questionnaires on stroke and epilepsy were developed, and two medical student groups were followed up in this 2013 longitudinal observational study. The students answered a KDS1, and attended a traditional lecture on one of the topics. They also accessed a VLE to apply the MC/DW method on stroke or epilepsy. We applied the same questionnaire (KDS2 and KDS3, respectively), one month and 5-6 months after the KDS1. We analyzed the mean KDS1 score of all the students, and the mean pairwise of those who accessed and those who did not access the VLEs during these three stages. An opinion survey was applied, and the results were analyzed by descriptive statistics. Results 87 students participated in the study, but six were excluded as they did not answer the questionnaires. The KDS1 general mean score was 1.59 (SD0.71). We found that 66 students (81.5%) accessed the VLE, showing a significant improvement in diagnostic skills in the KDS2 (mean5.65, p<0.05) and KDS3 (mean 4.57, p<0.05), with non-significant variations for those who did not access it. The MC was considered at least good for 62 students (94%), with 52 students (78.8%) finding that a checklist was sufficient to clear up all their DW doubts. Conclusions The MC/DW method in VLE proved to be effective for improving the diagnostic capability of the undergraduate medical students in the long term, and it was well accepted by the students. It presents several positive pedagogical characteristics and can be replicated.

Abstract Purpose: To investigate inhibitory effect of Astragalus polysaccharide (APS) on osteoporosis in ovariectomized rats by regulating FoxO3a/Wnt2 signaling pathway. Methods: Postmenopausal osteoporosis (PMOP) animal model was developed by excising the bilateral ovaries of rats. The model rats were administered with APS (200 mg/kg, 400 mg/kg, 800 mg/kg) by intragastric administration once daily for 12 weeks. Bone density, bone metabolism index and oxidative stress index were measured in all groups. Furthermore, the regulation of APS of FoxO3a / Wnt2 signaling pathway was observed. Results: APS has an estrogen-like effect, which can increase bone mass, lower serum ALP and BGP values, increase blood calcium content, and increase bone density of the femur and vertebrae in rats. At the same time, APS can increase the bone mineral content of the femur, increase the maximum stress, maximum load and elastic modulus of the ovariectomized rats, improve oxidative stress in rats by increasing the gene expression of β-catenin and Wnt2 mRNA and inhibiting the gene expression of FoxO3a mRNA. Conclusion: Astragalus polysaccharide can effectively alleviate oxidative stress-mediated osteoporosis in ovariectomized rats, which may be related to its regulation of FoxO3a/Wnt2/β-catenin pathway.

Abstract Introduction The use of 3D imaging in the medical field has proven to be a benefit to doctors when diagnosing patients. As for different medical applications, 3D visualization systems have advantages in terms of a better spatial understanding of anatomical structures, better performance of tasks that require high level of dexterity, increased learning performance, and improved communications with patients or between doctors. Methods In this technical report, we show how to employ a multi-view autostereoscopic system to provide 3D images without any special glasses or equipment, describing a new way to obtain 3D visualization using sets of 2D images instead of real volumetric data such as magnetic resonance imaging (MRI) or computed tomography (CT). We also propose an application of the images in neuroanatomy. Results We obtained three-dimensional images of anatomical parts for visualization without glasses with resolution of 336 × 210 pixels’. Conclusion The proposed method was able to generate three-dimensional high-resolution images and has great potential to be used in various areas such as anatomy and physiological studies.

SnO2 nanofibers were fabricated by calcination of the electrospun PVP/SnCl4 composite nanofibers. For the first time, SnS nanofibers and SnSe nanofibers were successfully synthesized by double-crucible sulfurization and selenidation methods via inheriting the morphology of SnO2 nanofibers used as precursors, respectively. X-ray diffraction (XRD) analysis shows SnS nanofibers and SnSe nanofibers are respectively pure orthorhombic phase with space group of Pbnm and Cmcm. Scanning electron microscope (SEM) observation indicates that the diameters of SnS nanofibers and SnSe nanofibers are respectively 140.54±12.80 nm and 96.52±14.17 nm under the 95 % confidence level. The photocatalytic activities of samples were studied by using rhodamine B (Rh B) as degradation agent. When SnS or SnSe nanofibers are employed as the photocatalysts, the respective degradation rates of Rh B solution under the ultraviolet light irradiation after 200 min irradiation are 92.55 % and 92.86 %. The photocatalytic mechanism and formation process of SnS and SnSe nanofibers are also provided. More importantly, this preparation technique is of universal significance to prepare other metal chalcogenides nanofibers.

RESUMO O conceito ‘Tempo é Cérebro “tem sido um grande foco na Campanha Mundial de conscientização sobre AVC. Objetivo Nós descrevemos experiência com Hackathon (junção das palavras hack+marathon) , um evento de 24 horas voltado a desenvolvimento de inovação tecnológica, centrada em torno de detecção de AVC. Método O Hackathon aconteceu durante o congresso da Associação de Estudante Brasileiros no Exterior (BRASA), envolvendo estudantes de engenharia e disciplinas tecnológicas. Resultados Quatro equipes completaram o desafio, duas optaram pelo desafio sobre AVC, uma propôs a detecção usando um sensor Fit-Bit e um telefone móvel para detecção e contato com a emergência. A outra equipe desenvolveu um jogo para as crianças detectarem AVC. Conclusão Hackathon pode focar a atenção em inovações e oportunidades de melhorias como um adicional a Campanha Mundial contra AVC, bem como em outras campanhas de conscientização para outras doenças ou problemas sociais.

ABSTRACT The ‘Time is Brain” concept has been a major focus in the World Stroke Awareness Campaign. Objective We describe our experience with a Hackathon (junction of hack+marathon), a 24 hour event of innovation- and technology-based project development, focused around detecting stroke. Method The Hackathon was held during a Brazilian Student’s union (BRASA) congress involving students from engineering and other technological disciplines. Results Four teamscompleted the 24-hour challenge; two teams opted the stroke challenge. One team proposed improving detection using a mobile sensor Fit-Bit combined with a smart-phone to contact emergency dispatch. The other team developed a game, in which kids would play a role as a neurologist; to diagnosis stroke with objective to increase awareness. Conclusion Hackathons can focus attention on innovation and improvement opportunities to support the World Stroke Campaign, as well as other campaigns to raise awareness for other health or social problems.

Tratamento intravenoso com rt- PA é eficaz na recanalização do acidente vascular cerebral isquêmico (AVCI) no prazo de até 4 horas e meia de seu início (OTT), com o melhor resultado visto naqueles tratados dentro de 90 minutos OTT. Apesar disso, poucos são tratados neste período de tempo. Do ponto de vista da melhoria de processos ou uma perspectiva de pensamento enxuto, há uma oportunidade potencial para reduzir o tempo ao eliminar etapas que não agregam valor em cada elemento da cadeia de sobrevivência do paciente com acidente vascular cerebral. A diminuição da OTT requer uma abordagem coordenada em conjunto para controlar e melhorar todos os elementos de OTT, a capacidade do paciente para reconhecer o início do icto até à administração da medicação. Encurtar esse tempo total deve ser um considerado um indicador da melhoria da qualidade no atendimento AVCI agudo.

Intravenous rt-PA is an effective recanalizing treatment for ischemic stroke within 4 and half hours from its onset (Onset-to-Treatment [OTT]), with the best result seen in those treated within 90 minutes OTT. Yet few patients currently are treated in this time frame. From the standpoint of process improvement or a lean thinking perspective, there is a potential opportunity to reduce the time by eliminating non-value-added steps in each element of the stroke survival chain. The reduction in one time element does not necessarily shift the OTT under 90 minutes. Most likely, the reduction in OTT requires a coordinated approach to track and improve all elements of OTT, from the patient’s ability to recognize the onset of stroke up to delivery of medication. Shortening this total time should be a considered an indicator of quality improvement in acute stroke care.