Kai Xin San ameliorates scopolamine-induced cognitive dysfunction

Kai Xin San(KXS, containing ginseng, hoelen, polygala, and acorus), a traditional Chinese herbal compound, has been found to regulate cognitive dysfunction; however, its mechanism of action is still unclear. In this study, 72 specific-pathogen-free male Kunming mice aged 8 weeks were randomly divided into a vehicle control group, scopolamine group, low-dose KXS group, moderate-dose KXS group, high-dose KXS group, and positive control group. Except for the vehicle control group and scopolamine groups(which received physiological saline), the doses of KXS(0.7, 1.4 and 2.8 g/kg per day) and donepezil(3 mg/kg per day) were gastrointestinally administered once daily for 2 weeks. On day 8 after intragastric treatment, the behavioral tests were carried out. Scopolamine group and intervention groups received scopolamine 3 mg/kg per day through intraperitoneal injection. The effects of KXS on spatial learning and memory, pathological changes of brain tissue, expression of apoptosis factors, oxidative stress injury factors, synapse-associated protein, and cholinergic neurotransmitter were measured. The results confirmed the following.(1) KXS shortened the escape latency and increased residence time in the target quadrant and the number of platform crossings in the Morris water maze.(2) KXS increased the percentage of alternations between the labyrinth arms in the mice of KXS groups in the Y-maze.(3) Nissl and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining revealed that KXS promoted the production of Nissl bodies and inhibited the formation of apoptotic bodies.(4) Western blot assay showed that KXS up-regulated the expression of anti-apoptotic protein Bcl-2 and inhibited the expression of pro-apoptotic protein Bax. KXS up-regulated the expression of postsynaptic density 95, synaptophysin, and brain-derived neurotrophic factor in the cerebral cortex and hippocampus.(5) KXS increased the level and activity of choline acetyltransferase, acetylcholine, superoxide dismutase, and glutathione peroxidase, and reduced the level and activity of acetyl cholinesterase, reactive oxygen species, and malondialdehyde through acting on the cholinergic system and reducing oxidative stress damage. These results indicate that KXS plays a neuroprotective role and improves cognitive function through reducing apoptosis and oxidative stress, and regulating synapse-associated protein and cholinergic neurotransmitters.

Risk factors for Clostridium difficile infection in cirrhotic patients

Background: Cirrhotic patients are susceptible to Clostridium difficile infection(CDI), however, the high risk factors are not clear. The present study aimed to identify the risk factors in cirrhotic patients with CDI. Methods: A total of 526 cirrhotic patients admitted to our hospital between May 2015 and October 2015 were included in this study. Stool samples were collected upon admission for the detection of CDI and toxin. CDI was monitored during the hospital stay. In total, 34 cases showed CDI. Then we analyzed the effects of age, sex, C. difficile colonization(CDC), multiple hospitalization, extended hospital stay, elevation of total bilirubin(TBIL), creatinine(Cr), Child-Pugh grade C, hepatic encephalopathy, hepatorenal syndrome, upper gastrointestinal hemorrhage, and exposure of antibiotics and proton pump inhibitor(PPI) on the CDI in cirrhotic patients. Results: Patients in the CDI group had more frequent CDC, multiple hospitalization, and extended hospital stay compared to those in the non-C. difficile infection(NCDI) group. Patients in the CDI group had higher TBIL and Cr, and higher frequency of Child-Pugh grade C, hepatic encephalopathy, upper gastrointestinal hemorrhage compared with those in the NCDI group. Multiple logistic regression analysis indicated that age > 60 years(OR = 1.689;95% CI: 1.135–3.128), multiple hospitalization(OR = 3.346;95% CI: 1.392–8.043), length of hospital stay > 20 days(OR = 1.564;95% CI: 1.113–2.563), hypoproteinemia(OR = 4.962;95% CI: 2.053–11.996), CDC(OR = 18.410;95% CI: 6.898–49.136), hepatic encephalopathy(OR = 1.357;95% CI: 1.154–2.368), and exposure of antibiotics(OR = 1.865;95% CI: 1.213–2.863) and PPI(OR = 3.125;95% CI: 1.818–7.548) were risk factors of CDI. Conclusions: Age > 60 years, multiple hospitalization, length of hospital stay > 20 days, hypoproteinemia, CDC, hepatic encephalopathy, and exposure of antibiotics and PPI were risk factors for CDI in cirrhotic patients. These may contribute to the early diagnosis and monitoring of CDI in clinical practice.

Prediction of Clostridium difficile infection based on gut microbial traits in patients with Clostridium difficile colonization

To the Editor : Cirrhotic patients usually require multiple hospitalizations due to upper gastrointestinal hemorrhage, abdominal infection, and hepatic encephalopathy. These patients need long-term hospital stay, and long-term application of proton pump inhibitors and antibiotics, which may result in Clostridium difficile infection(CDI) [1]. To our best knowledge, Clostridium difficile colonization(CDC) is the major risk factor for the pathogenesis of CDI.

Surface Carbon Chemical States of Ion Implanted AISI 440C Martensitic Stainless Steel

Carbon atoms segregate in the surface region for polished AISI 440C stainless steel After ion implanta tion, the surface carbon atoms exist in different forms. To elucidate their existence, surface structures and carbon chemical states o[ unimplanted, N~ implanted, Ti＋ implanted and N＋/Ti＋ co-implanted samples were analyzed by X-ray diffraction （XRD）, transmission electron microscopy （TEM） and X-ray photoelectron spectroscopy （XPS）. The results indicated that various phases form in the surface or subsurface region after ion implantation, while the surface topography of the samples remains intact. For polished unimplanted sample, besides some Fe3 C phase and C- C phase, Cr, Cs phase dominates its surface region. Little change of carbon chemical states occurs after N＋ ion im- plantation. For Ti＋ implanted sample, besides some metal oxycarbide phases, most carbon amorphous phases form in surface region. Concerning N＋/Ti＋ co-implantation, CrrCs compound as well as Fe^C phase dominates the sur face region while no C-C phase is found. In addition, compared with single ion implantation, N＋/Ti＋ co-implanta tion would increase the ion implantation depth significantly. The formed phases of the carbon atoms play an impor- tant role in affecting the surface properties of AISI 440C stainless steel.