POLYGENETIC MINERALIZATION OF THE EARLY PROTEROZOIC TONGKUANGYU METAPORPHYRY COPPER DEPOSIT IN THE ZHONGTIAO MOUNTAINS OF CHINA

The Tongkuangyu porphyry copper deposit in the Zhongtiao Mountains, China, is tectonically located on the southern margin of the North China platform and on the northern margin of the Late Archean Zhongtiaoshan intracontinental rift basin. The deposit occurs in a copper-bearing formation of tuffaceous variegated sandshale-K-rich bimodal volcanic rocks of the Tongkuangyu Formation of the Late Archean Jiangxian Group, and the orebodies are localized in a transition portion between tuffaceous variegated sandshale and bimodal volcanic rocks. The host rocks consist mainly of metagranodiorite-porphyry, meta-quartz monzonite-

Dose-dependent tandem responses of osteoblasts during osteogenesis

Irisin,a myokine mainly secreted from contracted skeleton muscle,plays a profound role in bone formation and remodeling.Although irisin has been revealed to elevate bone mass in vivo,details whether there is a dosedependent relationship between irisin and bone formation remain unclear.In this study,we explored the dosedependent effects of irisin on osteoblast proliferation and differentiation.Our results first demonstrated a remarkable increase in cell proliferation rate and viability in response to elevated concentrations of r-irisin,which was further enhanced over time.Notably,this increase was subject to complex dose-response relationships as the proliferation-enhancing effects of r-irisin may have a saturation point between 10 ng/ml and 100 ng/ml.Furthermore,we determined that 1,10,and 100 ng/ml r-irisin were able to upregulate the expression of osteogenic transcription factors(Runx2,Osx,and Atf4),as well as osteogenic markers(Alp,Col1a1 and Spp1),albeit without significant difference among these 3 concentrations.Interestingly,nutrient-depleted osteoblasts and those with standard culture showed distinct responses to higher doses of irisin regarding osteogenic differentiation.Further investigation is required to uncover the molecular mechanisms underlying the observed tandem effects of irisin on osteogenesis.

超声指导血液净化对创伤脓毒症患者血管内皮及凝血功能的影响

目的探讨以肺部超声及下腔静脉(IVC)为目标导向指导床旁连续血液净化对创伤后脓毒症合并急性肾功能损伤患者血管内皮和凝血功能的影响。方法前瞻性收集2020年1月—2022年11月柳州市中医医院重症医学科、中国人民解放军联勤保障部队第924医院急诊科、桂林市中医医院重症医学科、桂林市人民医院血液内科、广西壮族自治区人民医院急诊科收治的116例行连续血液净化治疗创伤后脓毒症合并急性肾功能损伤患者临床资料。男性84例,女性32例;年龄23~68岁,平均46.8岁;ISS(35.36±6.48)分;道路交通伤75例,高处坠落伤20例,重物撞击/挤压伤16例,其他5例。按数字表法随机分为试验组及对照组,每组58例。试验组以HR、MAP、肺部超声B线评分、IVC直径、IVC呼吸变异指数(SCI)指导调整每小时脱水量,容量控制在保持MAP>65 mmHg基础上,以维持IVC直径≤2.1 cm伴随呼吸变异率≤50%或IVC直径>2.1 cm伴随呼吸变异率>50%为目标,同时满足肺部超声B线评分≤5分为目标导向指导床旁连续血液净化治疗;对照组以常规维持MAP>65 mmHg指导床旁连续血液净化治疗。比较两组患者血液净化治疗对血管性假血友病因子(vWF)、APTT、D-二聚体(D-D)、WBC、血小板计数(Plt计数)、降钙素原(PCT)、氧合指数(PaO_(2)/FiO_(2))、APACHEⅡ评分、ICU住院时间及脱水量、28 d生存率指标变化的影响。结果经连续性血液净化治疗后,试验组vWF、APTT、D-D、WBC、PCT、APACHEⅡ评分及ICU住院时间显著少于对照组[(303.13±60.28)%vs.(331.19±65.01)%、(42.00±10.86)s vs.(46.51±12.66)s、(1.90±2.54)μg/mL vs.(4.03±3.41)μg/mL、(12.83±5.95)×10^(9)/L vs.(15.68±6.27)×10^(9)/L、(2.62±0.14)ng/mLvs.(3.37±0.52)ng/mL、(15.97±1.86)分vs.(17.03±2.07)分、(14.0±1.8)d vs.(15.7±2.2)d,P均<0.05];Plt、PO_(2)/FiO_(2)、脱水量显著高于对照组[(104.80±37.89)×10^(9)/L vs.(90.44±29.31)×10^(9)/L、253.37±36.25 vs.222.59±39.86、(339.69±51.15)mL vs.(305.68±52.75)mL,P均<0.05]。结论以肺部超声联合IVC作为容量管理指标指导创伤后脓毒症合并急性肾功能损伤患者连续血液净化治疗可有效改善患者的凝血功能,降低vWF水平,减少ICU住院时间,可广泛应用于临床。

The History of Controlling and Treating Infectious Diseases in Ancient China

Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious diseases.Whether in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases.All factors closely related to these three conditions can affect the prevalence of infectious diseases.China is one of the cradles of world civilization.The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases.In the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease.The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.

Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy:A New Technique for Selective Clamping of the Portal Vein

Objective:A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions.Methods:Rabbits undergoing hepatectomy were randomly assigned to 4 groups:intermittent portal triad clamping(PTC),intermittent portal vein clamping(PVC),intermittent portal vein blocker with an airbag-selective portal vein blood arrester(APC),and without portal blood occlusion(control).Hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate,blood loss,liver function,hepatic pathology,hepatic inflammatory cytokine infiltration,hepatic malondialdehyde levels,and proliferating cell nuclear antigen levels.Results:Liver damage was substantially reduced in the APC and PVC groups.The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals.Bleeding was significantly higher in the control group than in the other groups.The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy.Thus,more operative time was saved in the APC group than in the PVC group.Moreover,the total 7-day survival rate in the APC group was higher than that in the PTC group.Conclusion:Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy.This technique may also help prevent liver damage in patients requiring hepatectomy.

Inhibition of SLC26A4 regulated by electroacupuncture suppresses the progression of myocardial ischemia-reperfusion injury

Introduction:Myocardial ischemia-reperfusion(IR)injury has received widespread attention due to its damaging effects.Electroacupuncture(EA)pretreatment has preventive effects on myocardial IR injury.SLC26A4 is a Na+independent anion reverse transporter and has not been reported in myocardial IR injury.Objectives:Tofind potential genes that may be regulated by EA and explore the role of this gene in myocardial IR injury.Methods:RNA sequencing and bioinformatics analysis were performed to obtain the differentially expressed genes in the myocardial tissue of IR rats with EA pretreatment.Myocardial infarction size was detected by TTC staining.Serum CK,creatinine kinase-myocardial band,Cardiac troponin I,and lactate dehydrogenase levels were determined by ELISA.The effect of SLC26A4 on cardiomyocyte apoptosis was explored by TUNEL staining and western blotting.The effects of SLC26A4 on inflammation were determined by HE staining,ELISA,and real-time PCR.The effect of SLC26A4 on the NF-κB pathway was determined by western blotting.Results:SLC26A4 was up-regulated in IR rats but downregulated in IR rats with EA pretreatment.Compared with IR rats,those with SLC26A4 knockdown exhibited improved cardiac function according to decreased myocardial infarction size,reduced serum LDH/CK/CK-MB/cTnI levels,and elevated left ventricular ejection fraction and fractional shortening.SLC26A4 silencing inhibited myocardial inflammation,cell apoptosis,phosphorylation,and nuclear translocation of NF-κB p65.Conclusion:SLC26A4 exhibited promoting effects on myocardial IR injury,while the SLC26A4 knockdown had an inhibitory effect on the NF-κB pathway.These results further unveil the role of SLC26A4 in IR injury.

Mucinous neoplasm of the appendix:A case report and review of literature

BACKGROUND Appendiceal mucinous neoplasms(AMNs),although not classified as rare,are relatively uncommon tumors most often discovered incidentally during colorectal surgery.Accurate identification of AMNs is difficult due to non-specific sym-ptoms,overlapping tumor markers with other conditions,and the potential for misdiagnosis.This underscores the urgent need for precision in diagnosis to pre-vent severe complications.CASE SUMMARY This case report describes the unexpected discovery and treatment of a low-grade AMN(LAMN)in a 74-year-old man undergoing laparoscopic hemicolectomy for transverse colon adenocarcinoma(AC).Preoperatively,non-specific gastroin-testinal symptoms and elevated tumor markers masked the presence of AMN.The tumor,presumed to be an AMN peritoneal cyst intraoperatively,was con-firmed as LAMN through histopathological examination.The neoplasm exhibited mucin accumulation and a distinct immunohistochemical profile:Positive for Ho-meobox protein CDX-2,Cytokeratin 20,special AT-rich sequence-binding protein 2,and Mucin 2 but negative for cytokeratin 7 and Paired box gene 8.This profile aids in distinguishing appendiceal and ovarian mucinous tumors.Postoperative recovery was uncomplicated,and the patient initiated adjuvant chemotherapy for the colon AC.CONCLUSION This case highlights the diagnostic complexity of AMNs,emphasizing the need for vigilant identification to avert potential complications,such as pseudomyxoma peritonei.

Acceptability of Immunization against COVID-19 by the Populations of the Kasenga State Health Area in the Uvira Health Zone, DR Congo

Introduction: COVID-19 was an emerging disease putting all public health systems in countries around the world in a state of emergency. To be able to prevent its spread and morbidity and mortality, several appropriate strategies were necessary, such as vaccination. The latter has been the subject of controversy. The objective of the present study is therefore to evaluate the factors associated with the acceptance of this vaccine within the population of the Kasenga State Health Area. A result which will shed light on future strategies to be put in place for possible new vaccines. Methodology: Is a prospective and analytical cross-sectional study conducted over a period of approximately 1 month from January 5 to February 5, 2024. A survey questionnaire in Kobotoolbox was useful for collecting data. STATA software was very important for us in analyzing the data collected. Results: Prevalence of vaccination against COVID-19 among the population of the Kasenga State Health Area is 37.5% (28.4 - 45.6). The study revealed that reluctance is observed among most of the population for different reasons, including, first and foremost, the deliberate aspect of not wanting to take the vaccine (46.6%) and rumors that this antigen is dangerous and harmful (32.9%). 72.5% of respondents believe that the COVID-19 vaccine is a fabrication, unhealthy and that the disease itself never existed. The study proved that there was a statistical relationship between age (p = 0.001) and adherence to vaccination. And the refusal of respondents to recommend the vaccine to loved ones was a factor associated with non-adherence to vaccination (OR = 7.901, 95% IC [3.028 - 20.615], p = 0.000). Conclusion: Vaccination against COVID-19 was not well accepted by the population of the study site. Raising public awareness and involving community leaders and political-administrative authorities, which has not been done well, would play an important role in the good perception of the disease, of the vaccine and therefore in its adherence.

Circulating microRNA expression and nonalcoholic fatty liver disease in adolescents with severe obesity

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases in children and adolescents.NAFLD ranges in severity from isolated hepatic steatosis to nonalcoholic steatohepatitis(NASH),wherein hepatocellular inflammation and/or fibrosis coexist with steatosis.Circulating microRNA(miRNA)levels have been suggested to be altered in NAFLD,but the extent to which miRNA are related to NAFLD features remains unknown.This analysis tested the hypothesis that plasma miRNAs are significantly associated with histological features of NAFLD in adolescents.AIM To investigate the relationship between plasma miRNA expression and NAFLD features among adolescents with NAFLD.METHODS This study included 81 adolescents diagnosed with NAFLD and 54 adolescents without NAFLD from the Teen-Longitudinal Assessment of Bariatric Surgery study.Intra-operative core liver biopsies were collected from participants and used to characterize histological features of NAFLD.Plasma samples were collected during surgery for miRNA profiling.A total of 843 plasma miRNAs were profiled using the HTG EdgeSeq platform.We examined associations of plasma miRNAs and NAFLD features using logistic regression after adjusting for age,sex,race,and other key covariates.Ingenuity Pathways Analysis was used to identify biological functions of miRNAs that were associated with multiple histological features of NAFLD.RESULTS We identified 16 upregulated plasma miRNAs,including miR-193a-5p and miR-193b-5p,and 22 downregulated plasma miRNAs,including miR-1282 and miR-6734-5p,in adolescents with NAFLD.Moreover,52,16,15,and 9 plasma miRNAs were associated with NASH,fibrosis,ballooning degeneration,and lobular inflammation,respectively.Collectively,16 miRNAs were associated with two or more histological features of NAFLD.Among those miRNAs,miR-411-5p was downregulated in NASH,ballooning,and fibrosis,while miR-122-5p,miR-1343-5p,miR-193a-5p,miR-193b-5p,and miR-7845-5p were consistently and positively associated with all histological features of NAFLD.Pathway analysis revealed that most common pathways of miRNAs associated with multiple NAFLD features have been associated with tumor progression,while we also identified linkages between miR-122-5p and hepatitis C virus and between miR-199b-5p and chronic hepatitis B.CONCLUSION Plasma miRNAs were associated with NAFLD features in adolescent with severe obesity.Larger studies with more heterogeneous NAFLD phenotypes are needed to evaluate miRNAs as potential biomarkers of NAFLD.

RELATIONSHIP AMONG EVAPORATION FLUX OF GROUNDWATER, DEPTH OF WATER TABLE AND NEGATIVE PRESSURE HEAD IN BARE SOIL

Evaporation of ground water is a part of moisture circulation in the field. And it is a main natural form in which water transmits from the ground water to the soil water and atmosphere water. According to the simulated experiments, we study the relationship among the evaporation, depth of groundwater table and negative pressure. By theoretical analysis of the experimental results, the main conclusions are drawn as follows. There are two abrupt points in every Q-H curve. The locations of the abrupt points are separately in step with the height of top of the capillary fringe and the height of maximal capillary rise in the soil section. When the depth of water table H is small, the evaporation flux of ground water is large. While the depth of water table exceeds the maximal capillary rise of media in vadose zone, the capillary rise breaks up and evaporation flux of groundwater is small. The water content ratio in ground surface tends to be zero and the surface of soil tends to be drought. These conclusions show that the maximal capillary rise of media in vadose zone is an important value in regulating rational depth of ground water to reduce the evaporation of ground water and to increase effective quantity of water resources. In the meantime, these conclusions are of important theoretical and practical significance to reduce the evaporation of ground water, to prevent and cure the salinization of soil, and to make full use of and protect water resources in the northern plains in China.

Iron Aggravates the Depressive Phenotype of Stressed Mice by Compromising the Glymphatic System

Dear Editor,The pathophysiologic al mechanisms underlying mood disorders including major depressive disorder(MDD)remain to be fully characterized.Iron is a key component in the development of the central nervous system and iron deficiency has been linked to impairments of mood and cognition[1].

ACE2-independent infection of T lymphocytes by SARS-CoV-2

SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19.However,whether lymphocytes are targets of viral infection is yet to be determined,although SARS-CoV-2 RNA or antigen has been identified in T cells from patients.Here,we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells(PBCs)or postmortem lung T cells,and the infectious virus could also be detected from viral antigen-positive PBCs.We next prove that SARS-CoV-2 infects T lymphocytes,preferably activated CD4+T cells in vitro.Upon infection,viral RNA,subgenomic RNA,viral protein or viral particle can be detected in the T cells.Furthermore,we show that the infection is spike-ACE2/TMPRSS2-independent through using ACE2 knockdown or receptor blocking experiments.Next,we demonstrate that viral antigen-positive T cells from patient undergone pronounced apoptosis.In vitro infection of T cells induced cell death that is likely in mitochondria ROS-HIF-1a-dependent pathways.Finally,we demonstrated that LFA-1,the protein exclusively expresses in multiple leukocytes,is more likely the entry molecule that mediated SARS-CoV-2 infection in T cells,compared to a list of other known receptors.Collectively,this work confirmed a SARS-CoV-2 infection of T cells,in a spike-ACE2-independent manner,which shed novel insights into the underlying mechanisms of SARS-CoV2-induced lymphopenia in COVID-19 patients.

Different cutoff values of methacholine bronchial provocation test depending on age in children with asthma

Background:Bronchial hyperresponsiveness (BHR) is a fundamental pathophysiological characteristic of asthma.Although several factors such as airway caliber can affect BHR,no study has established age-dependent cutoff values of BHR to methacholine for the diagnosis of asthma in children.We investigated the cutoff values of the methacholine challenge test (MCT) in the diagnosis of asthma according to age.Methods:A total of 2383 individuals aged from 6 to 15 years old were included in this study.MCTs using the five-breath technique were performed in 350 children with suspected asthma based on symptoms by pediatric allergists and in 2033 healthy children from a general population-based cohort.We determined the provocative concentration of methacholine producing a 20% decrease in forced expiratory volume in 1 second from baseline (PC20).A modified Korean version of the International Study of Asthma and Allergies in Childhood questionnaire was used to distinguish asthmatics and healthy subjects.Receiveroperator characteristic curve analysis was used to assess the cutoff value of PC20 for the diagnosis of asthma.Results:Cutoff values of methacholine PC20,which provided the best combination of diagnostic sensitivity and specificity,showed an increasing pattern with age:5.8,9.1,11.8,12.6,14.9,21.7,23.3,21.1,21.1,and 24.6 mg/mL at ages 6,7,8,9,10,11,12,13,14,and 15 years,respectively.Conclusion:The application of different cutoff values of methacholine PC20 depending on age might be a practical modification for the diagnosis of asthma in children and adolescents with asthmatic symptoms.

热带中西太平洋海域大眼金枪鱼摄食生态学

为了解热带中西太平洋海域大眼金枪鱼(Thunnus obesus)的摄食生态学特性,利用金枪鱼延绳钓作业方式,于2018年5月—2019年2月期间,对该海域(2°03′S~11°17′S、163°14′E~173°35′E)的682尾大眼金枪鱼进行了食性分析,并使用方差分析(ANOVA)和有序多元Logistic回归模型,结合圆形统计方法分析了叉长、性别、性腺指数等生物因素以及渔获水深、月相等时空因素对摄食生态位宽度和摄食强度的影响。结果表明:1)叉长范围在81~195 cm的大眼金枪鱼雌雄个体的性别比例为1∶1.85;2)空胃率为25.4%,而在非空胃的个体胃含物中,枪乌贼属(Loligo sp.)、虾类和沙丁鱼属(Sardina sp.)的出现频率较高,依次为40.3%、39.7%、30.1%;3)个体摄食强度以0~2级为主,空胃率随着叉长的增加而增加,高摄食强度的比例随着渔获水深的增加而增加;4)方差分析(ANOVA)结果显示,性别、叉长、月相等因素对Shannon-Wiener多样性指数H′和Pielou均匀度指数J均没有显著影响,但渔获水深对J具有显著影响(P=0.024);5)有序多元Logistic回归模型拟合结果显示,个体摄食强度随着叉长和性腺指数(P=0.030)的增加而减小,随着渔获水深的增加而增加(P=0.002),在满月阶段摄食强度较高而在新月前后摄食强度较低(边际显著,P=0.058)。

严重和复杂颈深部间隙感染治疗的思考

目的近年来颈深部间隙感染的发生率有增加的趋势,有时治疗十分棘手,本文通过复杂病例的分析以提高临床医生对本病的再认识和治疗选择。方法回顾分析2018年1月-2022年6月收治的7例严重和复杂颈深部间隙感染患者的临床资料。结果7例患者中男5例,女2例;年龄40~72岁,平均年龄56.86岁,其中大于50岁5例,小于50岁2例。4例患者合并糖尿病,感染部位以咽旁隙(6例)多见,其次是下颌下间隙(5例)和气管前间隙(5例)。所有患者均接受手术和抗生素治疗,其中5例颈侧切开包括2例颈胸联合切开引流,1例口内切开引流,1例经皮纵隔穿刺引流,1例气管切开。所有患者均治愈。最常见并发症是低蛋白血症(4例),其次是下行坏死性纵隔炎(3例)。结论复杂颈深部间隙感染多见于老年男性和糖尿病患者,早期诊断和及时治疗是减少严重并发症的关键,针对不同部位的感染,采用个体化治疗有助于缩短病程。

橡胶混凝土力学性能及疲劳性能研究

为研究40%掺量的橡胶混凝土的抗压强度和弹性模量性能,及低温环境对其影响规律,进行了抗压和弹性模量试验;对不同应力水平下的橡胶混凝土开展抗压疲劳试验,通过建立疲劳方程来描述不同混凝土的抗压疲劳特性。结果表明,40%体积掺量的橡胶混凝土抗压强度降低34.64%,弹性模量降低28.84%。-40℃环境下橡胶混凝土抗压强度提高3.53%,弹性模量提高16.28%。橡胶混凝土在应力水平0.75、0.80、0.85时疲劳寿命次数分别提高83.39%、73.71%、31.11%。选用单对数疲劳方程来描述混凝土疲劳特性,得到不同混凝土回归方程的相关系数都接近于1,可以较好地反应混凝土的疲劳特性,为橡胶混凝土在不同应力水平作用下疲劳寿命预测提供参考。

Sepsis-induced immunosuppression:mechanisms,diagnosis and current treatment options

Sepsis is a common complication of combat injuries and trauma,and is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.It is also one of the significant causes of death and increased health care costs in modern intensive care units.The use of antibiotics,fluid resuscitation,and organ support therapy have limited prognostic impact in patients with sepsis.Although its pathophysiology remains elusive,immunosuppression is now recognized as one of the major causes of septic death.Sepsis-induced immunosuppression is resulted from disruption of immune homeostasis.It is characterized by the release of antiinflammatory cytokines,abnormal death of immune effector cells,hyperproliferation of immune suppressor cells,and expression of immune checkpoints.By targeting immunosuppression,especially with immune checkpoint inhibitors,preclinical studies have demonstrated the reversal of immunocyte dysfunctions and established host resistance.Here,we comprehensively discuss recent findings on the mechanisms,regulation and biomarkers of sepsis-induced immunosuppression and highlight their implications for developing effective strategies to treat patients with septic shock.

Quantum Codes Do Not Increase Fidelity against Isotropic Errors

In this article, we study the ability of error-correcting quantum codes to increase the fidelity of quantum states throughout a quantum computation. We analyze arbitrary quantum codes that encode all qubits involved in the computation, and we study the evolution of n-qubit fidelity from the end of one application of the correcting circuit to the end of the next application. We assume that the correcting circuit does not introduce new errors, that it does not increase the execution time (i.e. its application takes zero seconds) and that quantum errors are isotropic. We show that the quantum code increases the fidelity of the states perturbed by quantum errors but that this improvement is not enough to justify the use of quantum codes. Namely, we prove that, taking into account that the time interval between the application of the two corrections is multiplied (at least) by the number of qubits n (due to the coding), the best option is not to use quantum codes, since the fidelity of the uncoded state over a time interval n times smaller is greater than that of the state resulting from the quantum code correction.

Medical consultation in ulcerative colitis:Key elements for improvement

Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

Vitamin E modulates androgen receptor gene expression to attenuate ovarian dysfunctions in a rat model of dehydroepiandrosterone-induced polycystic ovary

Objective:To investigate the protective effect of vitamin E in dehydroepiandrosterone(DHEA)-induced polycystic ovary in rats.Methods:Premature female Wistar rats were randomly allocated into four groups,with 7 rats in each group.Group栺received corn oil(vehicle)and served as the control group;group栻received 0.2 mL of 0.06 mg/g DHEA in corn oil;group栿received 200 mg/kg vitamin E;group桇received DHEA plus vitamin E.All treatments lasted for 15 days,with DHEA administered subcutaneously,while vitamin E and corn oil were administered orally.After the experiment,serum samples and ovaries were harvested for biochemical,immunohistochemical,hormonal,and histological analysis.The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction(qPCR).Results:The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats(P<0.05).Administration of vitamin E to DHEAtreated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats.The histological analysis showed reduced atretic and cystic ovaries,increased E-cadherin and Bcl-2 expression,and reduced expression of Bax in the DHEAtreated rats co-treated with vitamin E.The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats.Conclusions:Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic,antioxidant,and anti-apoptotic pathways.