ABSTRACT Introduction: Remote ischemic preconditioning (RIPC) is a new noninvasive myocardial protection strategy that uses blood pressure cuf inflation to simulate transient non-fatal ischemia to protect the myocardium and reduce ischemia-reperfusion injury. Sulfonylureas may mask the effects of RIPC due to their cardioprotec-tive effect. This meta-analysis aimed to evaluate whether RIPC, in the absence of sulfonylureas, reduces troponin release in patients undergoing cardiac surgery. Methods: We conducted a meta-analysis of randomized controlled clinical trials to determine whether RIPC can reduce postoperative troponin release in cardiac surgery patients undergoing cardiopulmonary bypass without treatment with sulfonylureas. The data were normalized to equivalent units prior to the analysis. A random-effects model was used to provide more conservative estimate of the effects in the presence of known or unknown heterogeneity. Results: Six studies with a total of 570 participants were included. The analysis showed that troponin release was lower in the RIPC group than in the control group at six hours (test of standardized mean differences = 0, Z=3.64, P<0.001) and 48 hours (Z=2.72, P=0.007) postoperatively. When the mean of cross-clamping time was > 60 minutes, RIPC reduced troponin release at six hours (Z=2.84, P=0.005), 24 hours (Z=2.64, P=0.008), and 48 hours (Z=2.87, P=0.004) postoperatively. Conclusion: In cardiac surgery patients who are not taking sulfonylureas, RIPC can reduce troponin release at six and 48 hours postoperatively; hence, RIPC may serve significant benefits in certain cardiac surgery patients.

ABSTRACT Introduction: Remote ischemic preconditioning (RIPC) is a new noninvasive myocardial protection strategy that uses blood pressure cuf inflation to simulate transient non-fatal ischemia to protect the myocardium and reduce ischemia-reperfusion injury. Sulfonylureas may mask the effects of RIPC due to their cardioprotec-tive effect. This meta-analysis aimed to evaluate whether RIPC, in the absence of sulfonylureas, reduces troponin release in patients undergoing cardiac surgery. Methods: We conducted a meta-analysis of randomized controlled clinical trials to determine whether RIPC can reduce postoperative troponin release in cardiac surgery patients undergoing cardiopulmonary bypass without treatment with sulfonylureas. The data were normalized to equivalent units prior to the analysis. A random-effects model was used to provide more conservative estimate of the effects in the presence of known or unknown heterogeneity. Results: Six studies with a total of 570 participants were included. The analysis showed that troponin release was lower in the RIPC group than in the control group at six hours (test of standardized mean differences = 0, Z=3.64, P<0.001) and 48 hours (Z=2.72, P=0.007) postoperatively. When the mean of cross-clamping time was > 60 minutes, RIPC reduced troponin release at six hours (Z=2.84, P=0.005), 24 hours (Z=2.64, P=0.008), and 48 hours (Z=2.87, P=0.004) postoperatively. Conclusion: In cardiac surgery patients who are not taking sulfonylureas, RIPC can reduce troponin release at six and 48 hours postoperatively; hence, RIPC may serve significant benefits in certain cardiac surgery patients.

Abstract Background This paper aims to assess the impact of antibiotic therapy management by clinical pharmacists on rational drug use (RDU) in the perioperative period of patients receiving retinal detachment surgery in China from the perspective of prescription structure. Methods: In this study, a retrospective study was used to compare the differences in the RDU between 233 patients (the experimental group) receiving medical treatment and 210 patients (the control group) without clinical pharmacist intervention. The data were collected with a set of indicators adjusted from the core medication use indicator proposed by the World Health Organization and the International Network of Rational Use of Drugs according to the background of China. Results: There were significant differences in average number of drugs per prescription (19.7 and 20.8, P = 0.001), percentage of drugs on the reimbursable list (98.32% and 72.4%, P = 0.003), and average treatment expenditure per prescription (555.3 yuan and 707 yuan) between the experimental group and the controlled group, while average number of antibiotics per prescription (4.2 and 4.3, P = 0.114), average number of injections per prescription (12.02 to 11.96, P = 0.804) were not changed significantly. Conclusions: More efforts are needed to improve the effectiveness of the antibiotic therapy management by clinical pharmacist on rational drug use, meanwhile the objective of cost-saving should be included in the service pattern of clinical pharmacy services.

Abstract Alcoholic beverages play an important role in social gatherings and the consumption of alcohol drinks keep increasing worldwide in recent years, especially during the COVID-19 pandemic months. The authentication of alcoholic beverage is usually evaluated by trained panels or chromatography analysis. Over the last few decades, intelligent sensory technology (IST) that imitate the human sensory organs have been developed for quality control and authentication of alcoholic beverages. The artificial sensing system consist of arrays of sensors with cross-sensitivity and various pattern recognition methods, which can be used to discriminate or classify the samples based on the detection requirements. Application of IST on wine authenticity have been extensively studied, however, application of IST in authentication of other alcoholic beverages lacks of systemic study. This paper firstly describes the basic mechanism of current IST instruments and then summarizes the applications of IST in alcoholic beverages authenticity assessments, including discrimination of varietal and geographical origins, detection of frauds and adulterations, discrimination of years of aging, distinction of brands and types, aroma analysis, detection of spoilage and off-flavors, and monitoring of the production process. The potential applications and future development of IST in the brewing industry are also discussed.

Abstract Machine learning (ML) featured on its ability of learning and extracting features from a large set of data and automatically building statistical models. Through cooperation with intelligent sensors, which is designed to imitate human organs to analyze the sensory characteristics of foods, ML-based intelligent sensory systems such as electronic nose (E-nose) and electronic tongue (E-tongue) are developed for sensing applications in food industry. Consumption of alcohol beverages keep growing worldwide in recent years and fraudulent activities are stimulated due to the high price of alcoholic drinks, which motivates the application of intelligent sensory technology with high efficiency and accuracy for real-time quality control. Thus, this paper firstly summarizes the novel intelligent sensors that is suitable for sensory evaluation and the advanced ML algorithms used to create intelligent systems. Then the paper describes the mechanism of commercial ML-enabled intelligent devices and summarizes their practical sensing applications on the real-time quality control of a variety of alcoholic beverages, in term of detection of frauds and adulterations, aroma analysis, monitoring of the production process, and correlation with human sensory perception. Finally, the potential applications and future opportunities of ML-enabled intelligent sensor systems in the alcohol industry are discussed.

Abstract Background: Acute kidney injury (AKI), which is mainly caused by sepsis, has high morbidity and mortality rates. CXCL8(3–72) K11R/G31P (G31P) can exert therapeutic effect on inflammatory diseases and malignancies. We aimed to investigate the effect and mechanism of G31P on septic AKI. Methods: An AKI mouse model was established, and kidney injury was assessed by histological analysis. The contents of serum creatinine (SCr) and blood urea nitrogen (BUN) were measured by commercial kits, whereas neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme-linked immunosorbent assay (ELISA) kits. The expressions of CXCL8 in serum and kidney tissues were determined using ELISA and immunohistochemical analysis, respectively. Apoptosis rate of renal tissue was detected by terminal deoxynucleotidyl transfer-mediated dUTP nick end labeling (TUNEL) analysis. The expressions of inflammatory cytokines were measured by quantitative real-time PCR and Western blot, respectively. The apoptosis-related proteins, JAK2, STAT3, NF-κB and IκB were determined by Western blot. Results: G31P could reduce the levels of SCr, BUN, HGAL and KIM-1 and inhibit the renal tissue injury in AKI mice. G31P was also found to suppress the serum and nephric CXCL8 expressions and attenuated the apoptosis rate. The levels of inflammatory cytokines, pro-apoptotic proteins were decreased, while the anti-apoptotic proteins were increased by G31P in AKI mice. G31P also inhibited the activation of JAK2, STAT3 and NF-κB in AKI mice. Conclusion: These results suggest that G31P could protect renal function and attenuate the septic AKI. Our findings provide a potential target for the treatment of AKI.

Abstract Objective This study aimed to determine the differences in learning style preferences among bachelor degree nursing students at Central South University and associate degree nursing students at the Vocational Health School in China. Methods This study was a cross-sectional survey using the Chinese version of the VARK questionnaire to assess preferred learning styles: 159 enrolled bachelor degree nursing students and 199 enrolled associate degree nursing students completed the questionnaire with a response rate of 96.8%. Results The bachelor degree nursing students tend to prefer a multimodal learning style (58.49%), which significantly differed from that of associate degree nursing students (45.77%). The kinaesthetic modality was the predominant unimodal learning style among the bachelor degree and associate degree nursing students (18.20% and 33.67%), and the read-write modality was the least popular modality (2.5% and 4.02%). Conclusion There are both differences and similarities between the learning style preferences of bachelor degree and associate degree nursing students. Educational background is one of the most critical factors that influence the learning style preference of nursing students. This finding may be necessary and beneficial for carrying out future curricula reform. In addition, further comprehensive research should be conducted to examine the relationships between learning style preferences and academic performance, as well as learning style preferences and teaching methods.

Abstract Objective This study aimed to determine the differences in learning style preferences among bachelor degree nursing students at Central South University and associate degree nursing students at the Vocational Health School in China. Methods This study was a cross-sectional survey using the Chinese version of the VARK questionnaire to assess preferred learning styles: 159 enrolled bachelor degree nursing students and 199 enrolled associate degree nursing students completed the questionnaire with a response rate of 96.8%. Results The bachelor degree nursing students tend to prefer a multimodal learning style (58.49%), which significantly differed from that of associate degree nursing students (45.77%). The kinaesthetic modality was the predominant unimodal learning style among the bachelor degree and associate degree nursing students (18.20% and 33.67%), and the read-write modality was the least popular modality (2.5% and 4.02%). Conclusion There are both differences and similarities between the learning style preferences of bachelor degree and associate degree nursing students. Educational background is one of the most critical factors that influence the learning style preference of nursing students. This finding may be necessary and beneficial for carrying out future curricula reform. In addition, further comprehensive research should be conducted to examine the relationships between learning style preferences and academic performance, as well as learning style preferences and teaching methods.

ABSTRACT Soda saline-alkali soil has double adverse effects on growth, morphogenesis and yield of the crops by creating a salinity stress and a high pH value in the rhizosphere surroundings of the plant. Seed priming can be an effective approach to enhance stress adaptation in seedlings growing in salinity stressed conditions. The present study examined the role of hydropriming and comprehensive seed priming with ZnSO4, CaCl2, betaine hydrochloride and GA3 to enhance the soda saline-alkali tolerance in soybeans (Glycine max [L.] Merr.) seedlings. An unprimed control treatment was also maintained for comparison. The results show that two seed priming treatments can effectively mitigate the negative effects of soda saline-alkali stress. Nevertheless, compared with hydropriming, soybean seedlings from the comprehensive seed priming treatment had better growth performance through accumulation of soluble sugar and free proline contents, enhancing the activities of superoxide dismutase (SOD) and catalase (CAT), decreasing the malondialdehyde (MDA) content formed from lipid peroxidation, increasing the photosynthetic pigment contents, maintaining a better membrane integrity of the chloroplasts and mitochondria, and generating more starch grains in the chloroplasts of spongy mesophyll cells under soda saline-alkali stress. In conclusion, our results suggest that soybean seedlings from comprehensive seed priming exhibited a higher tolerance to soda saline-alkali stress than the unprimed control treatment.

OBJETIVO: Reinternações frequentes por exacerbações agudas da DPOC (EADPOC) são um fator de risco independente para maior mortalidade e uso de recursos de saúde. A gravidade da doença e o nível de proteína C reativa (PCR) são preditores validados do prognóstico em longo prazo para tais pacientes. Investigamos a utilidade da combinação do nível sérico de PCR com a classificação de risco de exacerbação da Global Initiative for Chronic Obstructive Lung Disease (GOLD) para predizer a reinternação por EADPOC. MÉTODOS: Estudo observacional prospectivo de pacientes consecutivos hospitalizados por EADPOC no Peking University Third Hospital, in Pequim, China. Avaliamos a idade; gênero, história e carga tabágicas (anos-maço), função pulmonar, frequência de EADPOC no último ano; qualidade de vida; categoria de risco GOLD (A-D, D indicando maior risco); e nível sérico de PCR de alta sensibilidade na alta (PCRas-A). RESULTADOS: A amostra final consistiu em 135 pacientes. Desses, 71 (52,6%) foram reinternados ao menos uma vez durante o período de seguimento de 12 meses. A mediana (intervalo interquartílico) do tempo de reinternação foi de 78 dias (42-178 dias). A análise multivariada revelou que PCRas-A sérico ≥ 3 mg/L e categoria GOLD D foram preditores independentes de reinternação (razão de risco = 3,486; IC95%: 1,968-6,175; p < 0,001 e razão de risco = 2,201; IC95%: 1,342-3,610; p = 0,002, respectivamente). A ordem das combinações dos fatores por risco cumulativo de readmissão, da maior para a menor foi a seguinte: PCRas-A ≥ 3 mg/L e categoria GOLD D; PCRas-A ≥ 3 mg/L e categorias GOLD A-C; PCRas-A < 3 mg/L e categoria GOLD D; e PCRas-A < 3 mg/L e categorias GOLD A-C. CONCLUSÕES: O nível sérico de PCRas-A e a classificação GOLD são preditores independentes de reinternação por EADPOC, e seu valor preditivo aumenta quanto usados conjuntamente.

OBJECTIVE: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. METHODS: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). RESULTS: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D ≥ 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D ≥ 3 mg/L and GOLD category D; hsCRP-D ≥ 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. CONCLUSIONS: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination.

A investigação química das plantas Phyllanthus cochinchinensis (Euphorbiaceae) levou ao isolamento de três novos glicosídeos fenólicos, filantuosídeos A-C, juntamente com 12 compostos conhecidos. Suas estruturas foram determinadas com base em extensivas análises espectroscópicas e métodos químicos. Dentre eles, filantuosídeos A e B são dois glicosídeos fenólicos raros, com um esqueleto C6-C3-C6. A configuração absoluta dos filantuosídeos A e B foi estabelecida por dicroísmo circular elétrico calculado (ECD) usando teoria do funcional da densidade e a sua abordagem dependente do tempo (TDDFT). Os compostos isolados também tiveram sua citotoxicidade e atividade antimicrobial testadas.

Chemical investigation of the whole plants of Phyllanthus cochinchinensis (Euphorbiaceae) led to the isolation of three new phenolic glycosides, phyllanthuosides A-C, together with 12 known compounds. Their structures were established on the basis of extensive spectroscopic analysis and chemical methods. Among them, phyllanthuosides A and B are two of the rare phenolic glycosides, featuring with a C6-C3-C6 skeleton. The absolute configurations of phyllanthuosides A and B were established by calculated electric circular dichroism (ECD) using time dependent density functional theory (TDDFT). The isolates were also tested for their cytotoxicity and antimicrobial activity.

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new technique. This study describes our initial experience of NOTES and investigates the feasibility of transumbilical endoscopic cholecystectomy (TUEC). METHODS: Eight domestic pigs were submitted to TUEC. After establishment of pneumoperitoneum, a bi-channel endoscope was placed through an infra-umbilical trocar. The gallbladder fundus was lifted by a grasper. The cystic duct and artery was dissected with a flexible hook and clipped by a clip fixing device. The specimen was extracted through the infra-umbilical trocar. RESULTS: The mean operation time was 114 minutes, ranging from 75 to 155 minutes. All the gallbladders were removed successfully. There was one case of subtotal resection, two cases of bleeding and three cases of bile leakage. CONCLUSION: Transumbilical endoscopic cholecystectomy is feasible although it needs more support of experiments and techniques before being applied on human subjects.