Bioactive constituents and action mechanism of Xiaoyao San for treatment of non-alcoholic fatty liver disease

Xiaoyao San(XYS)is a classic Chinese medicine prescription.It is traditionally used to relieve syndrome of“liver stagnation and spleen deficiency”,a common syndrome type in traditional Chinese medicine,through soothing liver,tonifying spleen,and nourishing blood.Correspondingly,XYS has long application in the treatment of depression,dyspepsia and liver diseases.Given the rising of cutting-edge researches on XYS,there’s a significant need to diligently uncover the bioactive constituents and action mechanisms of XYS for treating non-alcoholic fatty liver disease accordingly.

Leptin promotes proliferation and invasion of osteosarcoma cells by upregulating the expression of SIRT1

Osteosarcoma(OS)is a primary high-grade malignant bone neoplasm,and the prognosis ofOS remains poor due to early metastasis.Leptin plays an essential role in tumorigenesis,but the role of leptin in the development of OS is still not fully understood.In this study,we used a human osteosarcomaMG-63 cell line as an experimentalmodel.MG-63 cells were treated with leptin,and cell proliferation,apoptosis,adhesion,invasion,and gene expression,were evaluated.The results showed that leptin promoted proliferation,decreased adhesion,suppressed apoptosis,and promoted invasion,of MG-63 cells.Moreover,the expression of SIRT1 was upregulated in MG-63 cells exposed to leptin.Furthermore,MMP-2,8,and 9 were significantly upregulated by SIRT1,while SIRT1 knockdown inhibited the proliferation and invasion of MG-63 cells.In conclusion,our results suggest that leptin promotes OS cell proliferation and invasion by inducing the expression of SIRT1.

Association between exposure to particulate matter during pregnancy and birthweight:a systematic review and a metaanalysis of birth cohort studies

Studies of the associations between maternal exposure to particulate matter(PM) and risk of adverse effects on fetal growth are inconsistent and inconclusive. This question can be well answered by carefully designed birth cohort studies; however, so far the evidence from such studies has not come to the same conclusion. We sought to evaluate the association between maternal exposures to PM and low birthweight(LBW) enrolling 14 studies from 11 centers,and to explore the influence of trimester and exposure assessment methods on between-center heterogeneity in this association. Data were derived from PubMed, Embase, Google Scholar, CNKI, and WanFang database, references from relevant articles, and results from published studies until March 2017. Using a random-effects meta-analysis, we combined the coefficient and odds ratios(OR) of individual studies conducted among 14 birth cohort studies.Random-effect meta-analysis results suggested that a 17% and 6% increase in risk of LBW was relevant to a 10 μg/m^3 rise in PM_(2.5) and PM_(10) exposure concentrations at the 3 rd trimester(pooled odds ratios(OR), 1.17 and 1.06; 95%confidence interval(CI), 0.94-1.46 and 0.97-1.15, respectively), but the null value was included in our 95% CI. Our results showed that exposure to PM_(2.5) and PM_(10) during pregnancy has a positive relevance to LBW based on birth cohort studies. However, neither reached formal statistical significance. Negative impacts on outcomes of birth is implied by maternal exposure to PM. Further mechanistic researches are needed to explain the connection between PM pollution and LBW.

Interpretation of breast cancer screening guideline for Chinese women

Breast cancer is the most common malignant tumor in Chinese women.Early screening is the best way to improve the rates of early diagnosis and survival of breast cancer patients.The peak onset age for breast cancer in Chinese women is considerably younger than those in European and American women.It is imperative to develop breast cancer screening guideline that is suitable for Chinese women.By summarizing the current evidence on breast cancer screening in Chinese women,and referring to the latest guidelines and consensus on breast cancer screening in Europe,the United States,and East Asia,the China Anti-Cancer Association and National Clinical Research Center for Cancer(Tianjin Medical University Cancer Institute and Hospital)have formulated population-based guideline for breast cancer screening in Chinese women.The guideline provides recommendations on breast cancer screening for Chinese women at average or high risk of breast cancer according to the following three aspects:age of screening,screening methods,and screening interval.This article provides more detailed information to support the recommendations in this guideline and to provide more direction for current breast cancer screening practices in China.

How do Patients with Schizophrenia Perceive Relatives’ Levels of Expressed Emotions? A Brief Patient Rated Scale

Background : Patients’ perspective on relatives’ attitude and behaviour towards them (Expressed emotion—EE) may be an important addition to the current focus on relatives’ perspective only, as measured by Camberwell Family Interview (CFI) or other methods. Based on the theory of EE, we have designed a brief, three-item questionnaire completed by patients, named Felt Expressed Emotion Rating Scale (FEERS). FEERS measures the patient’s experience of criticism (Cri) and emotional over involvement (i.e. worry (Wo), and control (Con). Aims: To investigate the test-retest reliability of the FEERS and associations between the FEERS and the CFI and to which extent FEERS scores were modified by severity of psychotic symptoms, cognitive function, patient mood and amount of face-to-face contact with relatives. Methods : Forty-five patients with schizophrenia and related psychoses admitted to a psychiatric hospital and 67 relatives were included. Assessments included FEERS, CFI and Positive and Negative Syndrome Scale (PANSS). Results : FEERS-Cri test-retest intra-class correlation (ICC1,1) was 0.71 among patients with low total PANSS scores, low cognitive impairment (0.59) and depression (0.63). For low levels of cognitive impairment, the ICCs of the FEERS-Wo and the FEERS-Con were 0.62 and 0.83, respectively. The FEERS-Cri and FEERSHowWo correlated significantly with CFI-CC and CFI-positive comments, respectively. Among the relatives that the patient deemed “not at all critical” (low FEERS-Cri scores), 94% had low CFI-CC levels. Conclusions : The FEERS may be a brief, time-saving alternative for identifying relatives with low levels of criticism. However, illness severity, cognitive function and mood influence FEERS test-retest reliability and link to CFI.

Comparison of the anterior and posterior approach in treating four-level cervical spondylotic myelopathy

Background:The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial.The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.Methods:A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study.Perioperative information,intraoperative blood loss,clinical and radiological outcomes,and complications were recorded.Japanese Orthopedic Association(JOA)score,36-item short form survey(SF-36)score and cervical alignment were assessed.Results:There were no significant differences in JOA scores between the anterior and posterior group preoperatively(11.6±1.6 vs.12.1±1.5),immediately postoperatively(14.4±1.1 vs.13.8±1.3),or at the last follow-up(14.6±1.0 vs.14.2±1.1)(P>0.05).The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values.The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up.The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value(69.4 vs.61.7).Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively(-2.0°±7.3°vs.-1.4°±7.5°).The Cobb angle significantly improved immediately postoperatively(12.3°±4.2°vs.9.2°±3.6°)and at the last follow-up(12.4°±3.5°vs.9.0°±2.6°)in both groups compared with their preoperative values(P=0.00).Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.Conclusions:Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features.However,the JOA score recovery rate and SF-36 score in the anterior group were significantly higher.Persistent axial pain could be a major concern when undertaking the posterior approach.

Association between fetal macrosomia and risk of obesity in children under 3 years in Western China: a cohort study

Background Fetal macrosomia,defined as birth weight equal or over 4000 g,is a major concern for both neonatal and maternal health.A rapid increasing trend in fetal macrosomia is observed in different regions of China.We aimed to examine the association between fetal macrosomia and risk of childhood obesity in Western China.Methods All macrosomic live singletons (≥ 4000 g),and a random sample of singletons with normal birth weight (2500-3999 g) born in four districts of Chengdu,Western China,in 2011 were included in the cohort study.Maternal demographics,obstetric factors,labor and delivery summary at baseline were extracted from the Chengdu Maternal and Child Health Management System.Anthropometric measurements before 3 years and infant feeding information at around 6 months were also collected.Childhood obesity under 3 years was primarily defined as a weight-for-length/height z score ≥ 1.645 using the WHO growth reference.Secondary definitions were based on weight-for-age and body mass index (BMI)-for-age over the same cut-offs.Results A total of 1767 infants were included in the analyses,of whom 714 were macrosomic.After controlling for maternal age,parity,gestational age and anemia at the first antenatal visit,pre-pregnancy BMI,gestational weight gain,gestational age at birth,baby age and sex,and breastfeeding practices at 6 months,the risk of childhood obesity defined according to weight-for-length/height among macrosomic babies was 1.90 (95% confidence interval 1.04-3.49) times that of babies with normal birth weight.The risk of childhood obesity for macrosomic babies was 3.74 (1.96-7.14) and 1.64 (0.89-3.00) times higher based on weight-for-age and BMI-for-age,respectively.Conclusion Fetal macrosomia is associated with increased risk of obesity in children under 3 years in Western China.

Overcoming the Challenges Encountered in the Performance Appraisal of Faculty Members

Performance appraisal of teaching faculty who are involved in the act of delivery of medical education to prepare future doctors plays a pivotal role in measuring their competency level to train students,assessing the effectiveness in discharging their other roles,and acts as a motivating factor to continuously improvise and augment their knowledge and skills.However,the ground reality is that in most settings,this task is not acknowledged as an action for motivating a faculty member,but rather just an act of faultfinding.Upon the identification of these challenges,we must look for remedial measures to overcome them to streamline and enhance the effectiveness of the performance appraisal process.In conclusion,the performance appraisal of teaching faculty is an essential and indispensable activity.However,the success of performance appraisal,in terms of promoting professional development and organizational success,will depend a lot on the effective redressal of the existing challenges.

Re-epithelialization of the prostatic urethra after two-micron laser resection of the prostate

Dear Editor, Benign prostatic hyperplasia （BPH） is the most common genitourinary tract disease in elderly males.The two-micron laser combines the advantages of efficient resection and rapid vaporization, resulting in high-performance resection and excellent hemostasis in resection of the prostate adenoma, which makes it an effective and promising modality in BPH treatment. However, severe edema and necrosis of the remaining prostatic tissue after vaporesection of the prostatic adenoma may cause severe irritative and/or obstructive symptoms and may even result in the need for a second operation. Rapid wound re-epithelialization in the prostatic urethra can, however, reduce the incidence of postoperative complications after transurethral resection of the prostate （TURP）.

An efficient energy-management strategy for a DC microgrid powered by a photovoltaic/fuel cell/battery/supercapacitor

The outcome of this paper is to suggest an efficient energy-management strategy(EMS)for a direct-current(DC)microgrid(MG).The typical MG is composed of two renewable energy sources[photovoltaic(PV)systems and fuel cells(FCs)]and two energy-storage elements(lithium-ion battery and supercapacitor).An EMS was proposed to ensure optimal bus voltage with a power-sharing arrangement between the load and the sources.As a result,in the suggested DC MG,non-linear flatness control theory was used instead of the traditional proportional-integral control approach.The suggested EMS is intended to supply high power quality to the load under varying load conditions with fluctuating solar irradiation while considering the FC status.To validate and prove the effectiveness of the proposed EMS,a MATLAB®environment was used.In addition,the output power of the PV system was maximized using the particle swarm optimization algorithm as a maximum power point tracking(MPPT)technique to track the MPP of the 3000-W PV system under different irradiance conditions.The results show that the suggested EMS delivers a stable and smooth DC bus voltage with minimum overshoot value(0.1%)and improved ripple content(0.1%).As a result,the performance of the DC MG was enhanced by employing the flatness control theory,which provides higher power quality by stabilizing the bus voltage.