Recombinant Helicobacter bilis Protein P167 for Mouse Serodiagnosis in a Multiplex Microbead Assay

Infection of mice with Helicobacter bilis is widespread in research and commercial mouse colonies. Therefore, sensitive, specific, and high-throughput assays are needed for rapid and accurate testing of mice in large numbers. This report describes a novel multiplex assay, based on fluorescent microbeads, for serodetection of H. bilis infection. The assay requires only a few microliters of serum to perform and is amenable to a high-throughput format. Individual microbead sets were conjugated to purified, H. bilis-specific, recombinant proteins P167C and P167D and bacterial membrane extracts from H. bilis and Helicobacter hepaticus. For detecting H. bilis infection in the microbead multiplex assay, P167C and P167D provided significantly higher sensitivities (94 and 100%, respectively) and specificities (100 and 95%, respectively) than membrane extract (78% sensitivity and 65% specificity). Microbead multiplex assay results were validated by enzyme-linked immunosorbent assay. Purified recombinant proteins showed low batch-to-batch variation; this feature allows for ease of quality control, assay robustness, and affordability. Thus, recombinant antigens are highly suitable in the multiplex microbead assay format for serodetection of H. bilis infection.     

Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters

Study Objectives

Obtaining intravenous (IV) access in the emergency department (ED) can be especially challenging, and physicians often resort to placement of central venous catheters (CVCs). Use of ultrasound-guided peripheral IV catheters (USGPIVs) can prevent many “unnecessary” CVCs, but the true impact of USGPIVs has never been quantified. This study set out to determine the reduction in CVCs by USGPIV placement.

Methods

This was a prospective, observational study conducted in 2 urban EDs. Patients who were to undergo placement of a CVC due to inability to establish IV access by other methods were enrolled. Ultrasound-trained physicians then attempted USGPIV placement. Patients were followed up for up to 7 days to assess for CVC placement and related complications.

Results

One hundred patients were enrolled and underwent USGPIV placement. Ultrasound-guided peripheral IV catheters were initially successfully placed in all patients but failed in 12 patients (12.0%; 95 confidence interval [CI], 7.0%-19.8%) before ED disposition, resulting in 4 central lines, 7 repeated USGPIVs, and 1 patient requiring no further intervention. Through the inpatient follow-up period, another 11 patients underwent CVC placement, resulting in a total of 15 CVCs (15.0%; 95 CI, 9.3%-23.3%) placed. Of the 15 patients who did receive a CVC, 1 patient developed a catheter-related infection, resulting in a 6.7% (95 CI, 1.2%-29.8%) complication rate.

Conclusion

Ultrasound prevented the need for CVC placement in 85% of patients with difficult IV access. This suggests that USGPIVs have the potential to reduce morbidity in this patient population.     

Diastereoselective synthesis of novel spiro indanone fused pyrano[3,2-c]chromene derivatives following hetero-Diels–Alder reaction and in vitro anticancer studies

The development of concise methods for the synthesis of small functionalised spirocyclic molecules is important in the search of new bioactive molecules. To contribute this, here we represent a diastereoselective oxa-hetero-Diels–Alder reaction for the synthesis of novel spiro indanone fused pyrano[3,2-c]chromene derivatives and studied their in vitro anticancer activities. Using previously less explored cyclic ketone i.e. indane-1,3-dione and 3-vinyl-2H-chromene derivatives, we obtained novel spiro-heterocyclic frameworks at the interphase between “drug-like” molecules and natural products. Various spiro indanone fused pyrano[3,2-c]chromene derivatives were synthesized regiospecifically bearing a quaternary stereocenter in high yields (up to 85%) with excellent diastereoselectivity in toluene using 4 Å MS as additive under reflux condition at 120 °C. In vitro cytotoxic studies of these compounds against MCF-7 (breast cancer), HCT-116 (colon cancer), H-357 (oral cancer), MD-MB-231(Breast cancer) cell lines were evaluated by MTT {3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide} assay in vitro. The screening results revealed that many of the compounds are showing moderate to high levels of anticancer activities against the tested cancer cell lines and some displayed potent inhibitory activities in comparison to the commercial anticancer drug 5-fluorouracil (5-FU). Among the series, compound 3′c showed most potent cytotoxicity (15.0–27.5 μM) in three cancer cell lines (MCF-7, HCT-116 and MD-MB-231).

Synthesis of novel spiro indanone fused pyrano[3,2-c]chromene derivatives following hetero-Diels–Alder reaction has been demonstrated and evaluated for their in vitro anticancer activity.     

Enhanced ridge preservation by bone mineral bound with collagen-binding synthetic oligopeptide: a clinical and histologic study in humans

Background: The ridge‐preservation technique has been applied with membrane alone or membrane plus graft. Synthetic peptides, mimicking bioactive growth factor or extracellular matrix protein, have been attempted to provide an active surface of the biomaterials in inducing bone formation while alleviating the limitations of whole protein such as short half‐life, immunologic responses. The aim of the present clinical study is to examine the osteogenic effect of synthetic oligopeptide–coated bone mineral compared to bone graft without peptide when applied with collagen membrane in a ridge‐preservation technique. Methods: Synthetic oligopeptide from the collagen‐binding domain of osteopontin was chemically synthesized and coated onto the surface of bone mineral particulates. Ridge preservations were performed at 44 extraction sites in 42 patients (20 males and 22 females). Analyses of clinical parameters and histomorphometric evaluations were conducted to compare the osteogenic effects of the grafts between baseline and 6 months. Results: In the bone grafts of the control group treated without synthetic peptide, new bone formation was only seen around borders and basal areas. However, new bone was observed broadly in the defects of the test group treated with synthetic peptide–coated bone mineral, as seen not only at peripheries but also in the central and coronal parts of bone cores in the defects. The average percentage of new bone formation was significantly higher in the test group (5.3% ± 8.3% versus 10.4% ± 4.6%). The contact percentages between the graft particles and the new bone were 8.2% ± 11.3% for the control group and 20.4% ± 7.5% for the test group (P <0.05). Conclusions: The ridge‐preservation approach using synthetic oligopeptide–coated bone mineral with collagen membrane effectively prevented the resorption of hard tissue with higher bone‐to‐graft contact, and the oligopeptide‐coated bone may be a choice for ridge‐preservation procedures while assuring new bone formation.     

Modified Split‐Cast Technique: A New,Timesaving Clinical Remount Technique

Interocclusal discrepancies can be eliminated by a clinical remount procedure, but most practitioners avoid it because of the time involved. This article introduces a new timesaving method, the modified split‐cast technique. It uses a semi‐adjustable articulator, tin foil as plaster separator, and an addition‐type, silicone bite‐registration material. The technician does most of the remounting procedures before the denture delivery appointment, so the dentist spends very little time chairside to complete the clinical remount procedure. Compared with the conventional and two other remounting techniques, the new technique is faster and easier to manipulate.     

Differential response to lipid peroxidation in male and female mice with age: correlation of antioxidant enzymes matters

The aim of this study was to correlate the activity of superoxide dismutase, catalase and glutathion peroxidase in liver and brain of 1, 4 and 18 months old CBA mice of both sexes. In liver, decreased superoxide dismutase and increased glutathione peroxidase activities were observed during aging in male mice. In brain, the increase of catalase and glutathion peroxidase activity during aging was observed only in female mice. Regardless of tissue examined, different sex-related correlation pattern of antioxidant enzyme activity was demonstrated in young and old mice. The cooperation between antioxidant enzymes becomes more coherent with increased lipid peroxidation concentration in liver and brain of older female mice. On the contrary, in older male mice the link among three antioxidant enzymes becomes weaker, regardless of lipid peroxidation concentration which increased in liver and decreased in brain during aging. In older mice lower partial coefficient of correlation than pair correlation demonstrates the influence of the third party in the cooperation of two antioxidant enzymes. The results imply stronger correlative links in old female than male mice, which might explain why old females are better protected from oxidative stress than males.     

Clinical clues for differential diagnosis between verruca plana and verruca plana‐like seborrheic keratosis

Sometimes the clinical differentiation between verruca plana (VP) and VP‐like seborrheic keratosis (SK) could be challenged. However, there have been no studies on this issue to date. The aim of this study was to elucidate clinical and dermoscopic differences between these two diseases, and also to suggest a diagnostic algorithm of VP and VP‐like SK without skin biopsy. The patients who had lesions clinically considered as VP or VP‐like SK were the target of our study. We took clinical and dermoscopic photos with informed consent and conducted a questionnaire. All patients had their diagnoses confirmed by biopsy. Thirty‐three patients were enrolled in our study. Seventeen patients were finally diagnosed with VP (51.5%) and 16 patients with VP‐like SK (48.5%). In clinical findings, VP‐like SK showed significantly more scattered distribution than VP (P = 0.039), which exhibited more clustered or grouped distribution (P = 0.039). In dermoscopic findings, brain‐like appearance was more commonly observed in VP‐like SK (P = 0.003) whereas VP showed more red dots or globular vessels (P = 0.017) and even‐colored light brown to yellow patch (P < 0.001). Sex, onset age, the size of each lesion, location, color and shape showed no significant differences between them (P > 0.05). Based on our results, we suggest a diagnostic algorithm using Koebner's phenomenon, dermoscopic findings, distribution of each lesion and biopsy for multiple VP‐like lesions in adults, and we think it will be a very useful diagnostic tool in daily clinical dermatological practice.     

基于信息化平台的糖尿病患者自我管理质量评价指标体系的构建

目的:构建基于信息化平台的糖尿病患者自我管理质量评价指标体系,为开展依托信息化平台的糖尿病管理提供借鉴。方法:2018年8—11月,在文献回顾和专家会议法的基础上拟定指标体系初稿,通过德尔菲法对28名从事糖尿病诊疗、糖尿病护理、慢病管理、护理管理、护理教育等方面的专家进行2轮函询并构建最终指标体系。计算专家的积极性、权...     

Bilateral versus unilateral botulinum toxin injections for chronic anal fissure: a randomised trial

Background

Botulinum toxin injected into the internal anal sphincter is used in the treatment of chronic anal fissure but there is no standardised technique for its administration. This randomised single centre trial compares bilateral (either side of fissure) to unilateral injection.

Methods

Participants were randomised to receive bilateral (50?+?50 units) or unilateral (100 units) Dysport^® injections into the internal anal sphincter in an outpatient setting. Injection-related pain assessed by visual analogue scale was the primary outcome measure. Secondary outcomes were healing rate, fissure pain, incontinence, and global health scores.

Results

Between October 2008 and April 2012, 100 patients with chronic anal fissure were randomised to receive bilateral or unilateral injections. Injection-related pain was comparable in both groups. There was no difference in healing rate. Initially, there was greater improvement in fissure pain in the bilateral group but at 1 year the unilateral group showed greater improvement. Cleveland Clinic Incontinence score was lower in the unilateral group in the early post-treatment period and global health assessment (EuroQol EQ-VAS) was higher in the unilateral group at 1 year.

Conclusions

Injection-related pain was similar in bilateral and unilateral injection groups. Unilateral injection was as effective as bilateral injections in healing and improving fissure pain without any deterioration in continence.

     

Fragmented QRS complex in patients with implantable cardioverter defibrillator—Prevalence and predisposing factors

Background

Incidence of fragmented (fQRS) and predisposing factors in patients with implantable cardioverter-defibrillator (ICD) have not yet been established.AimTo examine incidence of fQRS, associated factors as well as predictive value in identifying site of coronary artery disease (CAD).