Effect of Ta_(2)O_(5)nanoparticles on bioactivity,composition,structure,in vitro and in vivo behavior of PEO coatings on Mg-alloy

The present study investigates the physical and chemical characteristics,behavior in vitro and in vivo,and biocompatibility of coatings containing Ta_(2)O_(5),which are obtained by plasma electrolytic oxidation(PEO)on MA8 magnesium alloy.The obtained coatings demonstrate in vivo biocompatibility and in vitro bioactivity.Compared to the base PEO coating,the layers containing Ta_(2)O_(5)facilitate the development of apatite in simulated body fluid,suggesting that the inclusion of nanoparticles improves bioactivity of the coatings.It was found that incorporation of Ta_(2)O_(5)nanoparticles increases roughness and porosity of the formed layers by increasing particle concentration in electrolytes for the PEO process contributing to sufficient soft tissue ingrowth in vivo.Based on in vivo studies,these coatings also provide favorable tissue response and minimal inflammatory reaction in comparison with the bare magnesium alloy due to protection of living tissues from deleterious corrosion events of magnesium implant such as local alkalization and intense hydrogen evolution.The results obtained in the present study concluded biocompatibility,tissue integration of the PEO coatings containing Ta_(2)O_(5)nanoparticles making them a promising protective layer for biodegradable magnesium implants.

Comparative analysis of pulmonary and extrapulmonary tuberculosis:A seven-year experience from a refugee host country,Turkiye

Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and foreign nationals.Methods:This study included patients aged 18 and over,both Turkish citizens and foreign nationals,diagnosed with PTB or EPTB between 2016 and 2022.All patients were divided into PTB and EPTB group,and demographic characteristics,clinical findings,and laboratory results were compared.Patients with both PTB and EPTB were not included in the comparison.Multivariate logistic regression analysis was conducted to identify potential risk factors for PTB.Results:Among the 261 TB cases included,46 patients(17.6%)had PTB,and 188(72%)had EPTB.The percentage of female patients was significantly higher(P=0.003)in EPTB compared to PTB group.While the prevalence of diabetes mellitus(P=0.002),hypertension(P=0.017),coronary obstructive pulmonary disease(P=0.001),congestive heart failure(P=0.005),coronary artery disease(P=0.001)and immunosuppressive medication use(P=0.017)were significantly higher in PTB patients than in EPTB patients.Multivariate logistical analysis reveals that male(OR 2.6,95%CI 1.3-5.5,P=0.009),diabetes mellitus(OR 2.7,95%CI 1.2-6.1,P=0.015),and asthma(OR 6.3,95%CI 1.2-33.9,P=0.032)were associated with an increased risk of PTB.Social security coverage(P<0.001)and regular employment status(P<0.001)were found to be lower and the presence of multidrug resistance(P=0.002),isoniazid resistance(P=0.012),and rifampin resistance(P=0.012)were found to be significantly higher in foreign-national TB patients comparing with Turkiye citizens.Conclusions:Patients with PTB need to be evaluated for comorbidities and PTB should be investigated in men,in patients with diabetes mellitus or asthma if there are clinical findings suspicious for TB.TB screening for foreign nationals upon entry into the country is essential for TB control and elimination.

Antibacterial HA-coatings on bioresorbable Mg alloy

In this study,a calcium-phosphate coating was formed on a Mg-Mn-Ce alloy by the plasma electrolytic oxidation(PEO).The antibiotic vancomycin,widely used in the treatment of infections caused by Staphylococcus aureus(S.aureus),was impregnated into the coating.Samples with vancomycin showed high bactericidal activity against S.aureus.The mechanical and electrochemical properties of the formed coatings were studied,as well as in vitro cytotoxicity tests and in vivo tests on mature male rats were performed.According to SEM,EDS,XRD and XPS data,coatings had a developed morphology and contained hydroxyapatite,which indicates high biocompatibility.The analysis of roughness of coatings without and with vancomycin did not reveal any differences,confirming the high roughness of the samples.During electrochemical tests,an increase in corrosion resistance by more than two times after the application of PEO coatings was revealed.According to the results of an in vivo study,after 28 days of the implantation of samples with calcium phosphate PEO coating and vancomycin,no signs of inflammation were observed,while an inflammatory reaction developed in the area of implantation of bare alloy,followed by encapsulation.Antibiotic release tests from the coatings show a sharp decrease in the concentration of the released antibiotic on day 7 and then a gradual decrease until day 28.Throughout the experiment,no significant deviations in the condition and behavior of the animals were observed;clinical tests did not reveal a systemic toxic reaction.

Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China

Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health concern.Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China.However,molecular epidemiological studies of Kashgar are lacking.Methods A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission patterns.Results A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated cases.Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,P<0.001.The estimated proportion of recent transmissions was 25.9%(432/1,668).Multivariate logistic analyses indicated that sex,age,occupation,lineage,and drug resistance were the risk factors for recent transmission.Despite the low rate of drug resistance,drug-resistant strains had a higher risk of recent transmission than the susceptible strains(adjusted odds ratio,1.414;95%CI,1.023–1.954;P=0.036).Among all patients with drug-resistant tuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB strains.Conclusion Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

Neutrophil-lymphocyte ratio is useful for the prognosis of patients with hepatocellular carcinoma

There is increasing evidence that neutrophil-lymphocyte ratio (NLR) may play a role in predicting recurrence in patients with hepatitis B virus-related hepatocellular carcinoma (HCC) after liver transplantation. In the original study by Yan et al, it was aimed to determine whether an elevated NLR is associated with tumor recurrence. Total tumor size (&#x0003e; 9 cm) and macro-vascular invasion were found to be more significant than NLR according to the multivariate logistic regression analysis. Therefore, substantive significance should be emphasized rather than NLR because total tumor size and macro-vascular invasion are easier and more expressive than NLR in assessing HCC recurrence. NLR and platelet-lymphocyte ratio (PLR) are markers which are easy to obtain and can be used as inflammation indicators. Moreover, assessment of both NLR and PLR may add some value as a good predictor of risk for post-liver transplantation HCC recurrence. However, while the study was constructed on whole blood analysis, further details about the features and performance characteristics of the whole-blood analyzer, and preanalytical/analytical variables should also be mentioned.

Expression of phosphatase and tensin homolog deleted on chromosome ten in liver of athymic mice with hepatocellular carcinoma and the effect of Fuzheng Jiedu Decoction

AIM： To explore the expression of phosphatase and tensin homolog deleted on chromosome ten （PTEN） in liver of athymic mice with hepatocellular carcinoma （HCC） and the effect of Fuzheng Jiedu Decoction （FJD）. METHODS： Forty eight male BALB/c athymic mice models were built by Bel-7402 with an indirect method. After 24 h of postoperation, the 48 athymic mice were distributed randomly into 4 groups： A, B, C, D, each group had 12 athymic mice. Group A were were treated by intragastric administration with FT207 （Tegafur） for 4 wk. Group B, C and D were treated by intragastric administration with FJD （complex prescription of Chinese crude drug） that had been delegated into 3 kinds of density as the low, middle, and high for 4 wk. At last, athymic mice were put to death, live time, volume of tumors, exponent of tumors and the tumor metastasis in livers were observed; and PTEN was detected in hepatic tissue, latero-cancer tissue and cancer tissue by immunohistochemistry. RESULTS： Four weeks later, the total survival rate in treatment group （A ＋ B ＋ C） was 50% and higher than the control group （0%） treated by FT207, （P 〈 0.01）. The survival rate in group A, B, C was higher than in group D, and except group A with D, there was significant differentces （Fisher＇s Exact Test P = 0.05 or 0.01）. And no differences were observed between the treatment groups and the control group in volume of tumors and exponent of tumors （P 〉 0.05）. Tumor metastasis in livers of the treatment group was less than the controls （Fisher＇s Exact Test, P = 0.021）. The result of immunohistochemistry showed that the intensity of PTEN in latero-cancer tissue was the highest, and then the hepatic tissue, the lowest was cancer tissue （Kruskal- Wallis test, X^2 = 60.67, P = 0.000）. It also showed that the intensity of PTEN in treatment groups （A, B, C） was higher than the control group （D） （F = 5.90, P = 0.002 in hepatic tissue and F = 15.99, P = 0.000 in latero-cancer tissue and X^2 = 26.08, P = 0.000 in cancer tissue）, and group B is the highest in the treatment groups （P 〈 0.05, r = 0.01. respectively）. However, there was no significant statistic difference between group A and group C （P 〉 0.05）. CONCLUSION： FJD can prolong the survival time and decrease tumor metastasis in livers of these experimental mice. Mechanisms of FJD healing HCC may partially be explained by enhancing the expression of PTEN in liver.

Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage?

Red cell distribution width (RDW) may play an important role in predicting steatohepatitis and liver fibrosis. In the original study, it was aimed to determine whether RDW could be used for this purpose or not. There are studies indicating that higher RDW is correlated well with components of metabolic syndrome. Because nonalcoholic fatty liver disease is now recognized as the hepatic manifestation of metabolic syndrome, possible impact of the accompanying confounders on the study findings should have been detailed. There may be a patient selection bias due to use of improper cut-off values for alcohol consumption and inclusion of only subjects with normal aminotransferase levels and normal abdominal ultrasonography. Patients without hepatosteatosis on ultrasonography and with any restriction of aminotransferase levels should have been included in the control group, because isolated aminotransferase elevation is not decisive in the diagnosis of hepatosteatosis. Although iron, vitamin B12 and folic acid deficiencies were included in exclusion criteria, functional forms of these molecules like methylmalonic acid, homocysteine, ferritin levels and total iron binding capacity, which are more sensitive and specific parameters for vitamin B12 and folic acid deficiencies, were not mentioned. Consequently, RDW, an inexpensive, non-invasive, but powerful indicator overlooked on whole blood analysis, itself without other inflammatory markers may not accurately provide information about progression of nonalcoholic steatohepatitis and fibrosis.

Computational Fluid Dynamics Simulation of the Upper Airway of Obstructive Sleep Apnea Syndrome by Muller Maneuver

This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.

痰涂片阳性肺结核患者成年家庭接触者患活动性结核病的风险

场所:土耳其伊斯坦布尔7个公共结核病防治所。目的:调查伊斯坦布尔新诊断的痰涂片阳性肺结核患者成年家庭接触者(≥15岁)患活动性结核病的风险。设计:对1997—2000年在伊斯坦布尔7家结防所登记的1 570例结核病成年家庭接触者的回顾性分析。结果:研究包括6 188例家庭接触者(平均接触者/线索病例:3.9),其中4 114例(67%)大于15岁(平均接触者/线索病例:2.6);3 310例(80.5%)参加了接触者调查。平均随访时间2.2年(1～4年);发现222例活动性结核病例(5.4%,95%可信区间5.2～5.6),第一年发现171例。活动性结核发病率为2 491/100 000(15～34岁年龄组发病率3 555/100 000,大于35岁年龄组发病率1 195/100 000,P<0.000 1)。活动性结核病发病率最高的在15～24岁(8.5%)和25～34岁(6.5%)年龄组。结论:涂片阳性肺结核患者的成年家庭接触者活动性结核发病率高。这样的高发病率说明化学预防治疗对于所有接触者,特别是年龄为15～34岁的接触者都是必要的,而不应仅仅用于儿童。

俄罗斯结核病治疗方案与短程化疗相比的成本—效益分析:结果来自西伯利亚托木斯克州

背景:西伯利亚的托木斯克州。目的:评估对WHO的Ⅰ类新结核病患者应用个体化俄罗斯治疗方案和短程化疗(SCC)方案的成本-效益。设计:分析家庭、社会作为一个整体所提供的两种治疗方法的成本,和住院2周(患者理论上不合作危险小)及2个月(患者理论上有不合作危险)的SCC的敏感性分析。结果以每个治愈病例的费用和挽救生命年(year of life saved)测量,治愈率以当地实施的试验为基础。结果:应用个体化俄罗斯治疗方案每个治愈患者的 费用为2295美元,与此相比,与此相比,应用SCC为1901美元。每个挽救生命年的费用分别为123美元和103美元。每个治愈患者的费用应用SCC住院治疗2个月为1457美元、2周为556美元,每挽救生命年的费用分别为79美元和30美元。结论:在托木斯克采用含2周和2个月住院治疗的SCC,能达到与用俄罗斯治疗方案相似的治愈率,同时社会和家庭两者均节省了大量的开支。

Lumin^(TM)光二极管荧光装置、荧光显微镜、萋-尼法诊断抗酸杆菌的比较

设计:在俄罗斯(样本量为502)及马其顿(样本量为205)开展跨地区研究。将荧光染色的痰涂片分别用以下显微镜观察:(1)由普通光学显微镜改装而成的Lumin^(TM)发光二极管显微镜(以下简称LED);(2)各实验室现有的传统荧光显微镜(CFM)。将相同的涂片用萋-尼法(ZN)进行复染,普通光学显微镜读片,比较2种荧光法与萋-尼法的结果。因为ZN复染结果不理想,为比较其敏感性及特异性,俄罗斯实验室回顾性地分析了前阶段实验室登记的直接ZN法涂片(n=791)。结果:马其顿实验室的数据表明,LED及CFM的敏感性为87.8%,而ZN复染传统显微镜镜检的敏感性为78.0%;在俄罗斯,所得到的敏感性分别为LED 72.8%,CFM 52.5%,ZN复染28.5%,直接ZN 55.6%。结论:相比于传统涂片镜检法,荧光法更敏感。普通光学显微镜改造后的LED诊断效果优于或等同于CFM。马其顿实验数据显示,LED与CFM的阳性发现率比ZN复染高出12%,这与其他报道的统计分析相符。俄罗斯实验室因未知原因导致ZN复染的诊断结果欠佳,而回顾性分析说明:相比于LED 72.8%的敏感性,直接ZN为55.6%,这与其他文献报道的荧光显微镜有优越性的观点一致。

Perioperative coagulation activation after permanent pacemaker placement

BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system’s parameters and how such parameters relate to different consequences after PM placement.AIM To assess the blood coagulation factor activity in PM patients throughout the perioperative period.METHODS Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor Ⅰ(FⅠ) and the activity of blood coagulation factors Ⅱ(FⅡ), Ⅴ(FⅤ), Ⅶ(FⅦ), Ⅷ(FⅧ), ⅸ(Fⅸ), ⅹ(Fⅹ), Ⅺ(FⅪ), Ⅻ(FⅫ). We used an automatic coagulometer Sysmex CA 660(Sysmex Europe, Germany) and reagents from Siemens(Siemens Healthcare Diagnostics Products GmbH, Germany).RESULTS The study included 146 patients. The activity of factors FⅤ [147.7(102.1-247.55)% vs 103.85(60-161.6)% vs 81.8(67.15-130.65)%, P = 0.002], FⅧ [80.4(60.15-106.25)% vs 70.3(48.5-89.1)% vs 63.7(41.6-88.25)%, P = 0.039], Fⅸ [86.2(70.75-102.95)% vs 75.4(59.2-88.3)% vs 73.9(56.45-93.05)%, P = 0.014], Fⅹ [188.9(99.3-308.18)% vs 158.9(83.3-230)% vs 127.2(95.25-209.35)%, P = 0.022], FⅪ [82.6(63.9-103.6)% vs 69.75(53.8-97.6)% vs 67.3(54.25-98.05)%, P = 0.002], FⅫ [87.6(67.15-102.3)% vs 78.9(63.4-97.05)% vs 81.2(62.15-97.4)%, P < 0.001] decreased at 7 and 30 d after surgery;FⅡ activity [157.9(109.7-245.25)% vs 130(86.8-192.5)% vs 144.8(103.31-185.6)%, P = 0.021] decreased at 7 d and increased at 30 d postoperatively. There were no statistically significant changes in the FVII activity within 30 d after PM placement [182.2(85.1-344.8)% vs 157.2(99.1-259)% vs 108.9(74.9-219.8)%, P = 0.128]. Subgroup analysis revealed similar changes only in patients on anticoagulant therapy. FⅫ activity decreased in patients on antiplatelet therapy [82(65.8-101.9)% vs 79.9(63.3-97.1)% vs 89.7(75.7-102.5)%, P = 0.01] 7 d after surgery, returning to baseline values at 30 d postoperatively.CONCLUSION PM placement and anticoagulant therapy were associated with decreased activity of clotting factors FⅤ, FⅧ, Fⅸ, Fⅹ, FⅪ, FⅫ in the postoperative period. FⅧ activity did not decrease within 30 d after PM placement, which may indicate endothelial injury caused by lead placement.

Beneficial Effects of Non-chemically Grown Traditional Rice/Rice Based Functional Food(NGTRF)in Nutritional Management of Nafld and Diabetes Mellitus

Non-communicable diseases(NCDs)are commonly associated with non-alcoholic fatty liver/non-alcoholic fatty liver disease(NAFL/NAFLD)for which no drugs or specific food are available either to control or to cure.We encounter promising results with NGTRF in nutritional Management of NAFLD and diabetes.Objective is to compare the effect of using NGTRF over routine western management(RWM)and Hela Nila Wedakama(HNW)patients with NCD,including metabolic syndrome,are prescribed NGTRF(produced by Hela Suwaya)and followed up.The five therapeutic categories are(1)RWM alone;(2)NGTRF alone;(3)NGTRF+RWM(in Galle);(4)NGTRF+RWM(in Gampaha);(5)NGTRF+RWM+HNW.According to clinical,biochemical and radiological profiles,majority of categoroes 2,3,4 and 5 are either controlled or cured effectively and sustainably compared to category 01.Preliminary evidence shows that effectiveness and sustainability of prescribing NGTRF is better.According to“Hela Suwaya”knowledge,genetic basis of food(conventional vs.traditional)and agronomic practices should be strongly considered while prescribing food.Traditional rice grown with toxin free Hela Suwaya“Hela Govithena”technology improves the micronutrient,prebiotic,probiotic and antioxidant profiles of food.Agrochemical farming reduces these parameters by reducing soil pH and biota.Functional foods produced by Hela Suwaya post-harvest food technology(such as rice-based porridge)will further improve these nutritional profiles.The resulting optimization of the disturbed liver function is the key factor behind this beneficial effect on whole NCD spectrum.This is observed as cured or reduced NAFL/NAFLD.We have already planned controlled clinical trials for further confirmation.Proper food-based intervention is therefore strongly suggested.

Constraints Hindering the Adoption of Scientific Dairy Farming Practices by Members and Non-members of Dairy Co-operative Societies （DCS）/Milk Producer Institutions （MPI）

The present study was conducted in four districts of Telangana State of India with 120 respondents in which 60 were members and other 60 were non-members of DCSs （Dairy Co-operative Societies）/MPIs （Milk Producer Institutions）. Constraints perceived in dairy farming and suggestions elicited by members and non-members were noted, tabulated and analyzed. The major constraints perceived by half or more than half of members were scarcity of water （91.67%）, lack of green fodder （88.33%）, preferring NS （natural service） than AI （Artificial Insemination） （83.33%）, negligence in feeding pregnant and dry animals （81.37%）, insufficient loan amount （78.33%）, tendency to feed only grass and brans （71.67%）, lack of availability of sufficient labour （70.00%）, lack of remunerative price for milk （66.67%）, high cost of feed （61.67%）, lack of fodder conservation （55.00%） and high cost of animals （50.00%）. Whereas major constraints perceived by non-members were scarcity of water （96.67%）, lack of green fodder （93.33%）, preferring NS than AI （88.33%）, lack of availability of sufficient labour （85.00%）, negligence in feeding pregnant and dry animals （83.33%）, tendency to feed only grass and brans （78.33%）, high cost of animals （75.00%）, complex procedure for obtaining loans （71.67%） and high cost of feed （66.67%）. Suggestions elicited by members majorly were providing subsidy for purchase of animals/providing loans on par with the cost of animal （81.67%）, enhancing the procurement price （70.00%）, providing more incentives （60.00%）, encouraging calf rearing （58.33%） and conducting frequent animal health camps （50.00%）. In case of non-members major suggestions elicited were conducting frequent animal health camps （68.33%） and providing subsidy on purchase of animals/providing loans on par with the cost of animal （58.33%）. Considering the above constraints perceived and suggestions elicited by dairy farmers a proper linkage strategy should be developed among private and public sectors in providing need based services to the dairy farmers.

The Epidemiological Characteristics of Pulmonary Tuberculosis——Kashgar Prefecture,Xinjiang Uygur Autonomous Region,China,2011-2020

Introduction:National Notifiable Disease Reporting System(NNDRS)plays an important role in the early detection and control of tuberculosis(TB)in China.This study analyzed the epidemiological characteristics of pulmonary tuberculosis(PTB)in Kashgar Prefecture,Xinjiang Uygur Autnomous Region,China from 2011 to 2020 to provide a scientific basis for developing TB control strategies and measures in Kashgar.Methods:The data were collected from the NNDRS,which included the geographical distribution,age,sex,occupation,and pathogenic classification of reported PTB cases in 12 counties/cities of Kashgar Prefecture from 2011 to 2020.Descriptive statistics were used to describe the characteristic of PTB epidemic in Kashgar.Results:There were 189,416 PTB cases reported during 2011–2020,with a mean annual PTB case notification rate(CNR)of 451.29/100,000.A rising trend in the rate of reported PTB between 2011 and 2017(χ2 trend=26.09,P<0.01)and a declining trend between 2018 and 2020(χ2 trend=314.44,P<0.01)were observed.The months with the highest reported number of PTB cases were March to May and November to December.The mean annual rate of reported PTB was 451.88/100,000 for males and 450.67/100,000 for females.In addition,19.76%of patients were bacteriologically-confirmed(Bac+)cases(37,425/189,416),and the mean annual Bac+CNR was 89.17/100,000,rising from 64.76/100,000 in 2011 to 139.12/100,000 in 2020(χ^(2)_(trend)=74.44,P<0.01).Conclusions:The CNR of reported PTB in Kashgar showed a significant declining trend in the past three years.Males,elderly population,winter and spring,and farmers as an occupation were the main factors associated with high incidence of tuberculosis in Kashgar.Targeted prevention and treatment of TB should be strengthened in key groups in this region.

Effect of Exercise on NAFLD and Its Risk Factors:Comparison of Moderate versus Low Intensity Exercise

Background and Aims: Lifestyle (exercise and dietary) modification is the mainstay of treatment for non-alcoholic fatty liver disease (NAFLD). However, there is paucity of data on effect of intensity of exercise in management of NAFLD, and we aimed to study the effect of variable intensities of exercise on NAFLD. Methods: The study was performed in the Department of Gastroenterology of the SCB Medical Col-lege, Cuttack and the Biju Patnaik State Police Academy, Bhu-baneswar. The subjects were police trainees [18 in a moderate intensity exercise group (MIG) and 19 in a low in-tensity exercise group (LIG)] recruited for a 6-month physical training course (261.8 Kcalorie, 3.6 metabolic equivalent in MIG and 153.6 Kcalorie, 2.1 metabolic equivalent in LIG). NAFLD was diagnosed by ultrasonography, with exclusion of all secondary causes of steatosis. All participants were eval-uated by anthropometry (weight, height, body mass index (BMI), waist circumference), assessed for blood pressure and biochemical parameters (blood glucose, liver function test, lipid profile, serum insulin), and subjected to transabdo-minal ultrasonography before and after 6 months of physical training, and the results were compared. Results: Both the groups had similar BMI, fasting plasma glucose, AST, gamma-glutamyl transpeptidase, insulin, and homeostatic model as-sessment-insulin resistance (known as HOMA-IR) (p>0.05). However, subjects in the LIG were older and had lower alanine transaminase, higher triglycerides and lower high-density lip-oproteins than MIG subjects. There was a significant reduc-tion in BMI (27.0±2.1 to 26.8±2.0;p=0.001), fasting blood glucose (106.7±21.6 to 85.8±19.0;p<0.001), serum trigly-cerides (167.5±56.7 to 124.6±63.5;p=0.017), total choles-terol (216.8±29.2 to 196.7±26.6;p=0.037), low-density lipoprotein cholesterol (134.6±21.4 to 130.5±21.9;p=0.010), serum aspartate transaminase (39.3±32.2 to 30.9±11.4;p<0.001), serum alanine transaminase (56.6 ±28.7 to 33.0±11.3;p<0.001) and HOMA-IR (2.63±2.66 to 1.70±2.59;p<0.001) in the MIG. However, changes in these parameters in the LIG were non-significant. Hepatic steatosis regressed in 66.7%of the NAFLD subjects in the MIG but in only 26.3% of the LIG NAFLD subjects (p=0.030). Conclusions:Moderate rather than low intensity physical activity causes sig-nificant improvement in BMI, serum triglycerides, cholesterol, serum transaminases and HOMA-IR, and regression of ultraso-nographic fatty change in liver among NAFLD subjects.

Luminal androgen receptor(LAR)subtype of triple-negative breast cancer:molecular,morphological,and clinical features

According to the classification presented by Lehmann BD(2016),triple-negative breast cancer(TNBC)is a heterogeneous group of malignant tumors with four specific subtypes:basal-like(subtype 1 and subtype 2),mesenchymal,and luminal androgen receptor(LAR)subtypes.The basal-like subtypes of carcinomas predominate in this group,accounting for up to 80%of all cases.Despite the significantly lower proportions of mesenchymal and LAR variants in the group of breast carcinomas with a TNBC profile,such tumors are characterized by aggressive biological behavior.To this end,the LAR subtype is of particular interest,since the literature on such tumors presents different and even contradictory data concerning the disease course and prognosis.This review is devoted to the analysis of the relevant literature,reflecting the main results of studies on the molecular properties and clinical features of the disease course of LAR-type TNBC carcinomas.

Multichannel Financing Reduces Economic Burden and Improves the Medical Security Level for Tuberculosis Patients

Tuberculosis(TB)is one of the main infectious diseases to simultaneously cause poverty and be caused by poverty.Reducing the economic burden of TB patients in China is essential to improving patient compliance and reducing the impact of the TB epidemic.In accordance with the national reform of the medical and health system and the current status of the country’s TB prevention and treatment service system,representatives of the government proposed the concept of a multichannel financing mechanism.

Microwave triggered multifunctional nanoplatform for targeted photothermal-chemotherapy in castration-resistant prostate cancer

Lacking a precise targeting strategy,castration-resistant prostate cancer(CRPC)is still hard to be treat effectively.Exploring treatment options that can accurately target CPRC is an important issue with urgent need.In this study,a novel nanotechnologybased strategy had been developed for the precise target treatment of CRPC.By combining microwaves and photothermal therapy(PTT),this nanoplatform,cmHSP70-PL-AuNC-DOX,targets tumor tissues with outstanding precision and achieves better anti-tumor activity by simultaneously eliciting photothermal and chemotherapeutic effects.From nanotechnology,cmHSP70-modified and thermo-sensitive liposome-coated AuNC-DOX were prepared and used for CRPC-targeted photothermal ablation and chemotherapy.Doxorubicin(DOX)was selected as the chemotherapeutic agent for cytotoxicity.In terms of the curative scheme,prostate tissues were firstly pre-treated with microwaves to induce the expression of heat shock protein 70(HSP70)and its migration to the cell membrane,which was then targeted by HSP70 antibody(cmHSP70)coated on the nanoparticles to achieve accurate drug delivery.The nanoplatform then achieved precise ablation and controlled release of DOX under external near-infrared(NIR)irradiation.Through the implementation,the targeting,cell killing,and safety of this therapeutical strategy had been verified in vivo and in vitro.This work establishes an accurate,controllable,efficient,non-invasive,and safe treatment platform for targeting CRPC,provides a rational design for CRPC’s PTT,and offers new prospects for nanomedicines with great precision.

Commentary on"Simple non-invasive biomarkers of advanced fibrosis in the evaluation of non-alcoholic fatty liver disease"

Dear Editor,We read with great interest the recently published article by Tapper et al.[1].In this study,the authors’intention was to describe the clinical predictors of advanced histology in a tertiary referral centre population,and to describe the rate of advanced histology in patients with‘normal’ultrasound findings in a cohort of liver-biopsy-proven,non-alcoholic fatty liver disease(NAFLD)or non-alcoholic steatohepatitis(NASH)patients.In conclusion,aspartate aminotransferaseto-platelet ratio(APRI)greater than 1.0 was found to be the most significant predictor of advanced fibrosis.Additionally,20%and 16.7%of patients without ultrasound-detected steatosis had advanced fibrosis and active NASH,respectively.In accordance with these findings,the authors suggested that patients with suspected NAFLD should routinely be evaluated for advanced liver disease,including non-invasive indices of fibrosis such as APRI,and that serious consideration should be given to liver biopsy.However,we would like to share our thoughts and contributions to the original study.