Objective: To develop a set of quality indicators (QIs) tailored to improve the care provided to children with juvenile idiopathic arthritis (JIA) in countries across the Asia-Pacific region. Methods: An adaptation of the Research and Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) was used. An initial set of 32 QIs was developed after a systematic search of the literature. These were presented to members of a Delphi panel composed of pediatric rheumatologists and other relevant stakeholders from the Asia Pacific League of Associations for Rheumatology Pediatric Special Interest Group (APLAR-Pediatric SIG). After each round, the mean scores for validity and reliability, level of disagreement, and median absolute deviation from the mean were calculated. Results: The panelists were presented with 32 QIs in two rounds of voting, resulting in the formulation of a final set of 22 QIs for JIA. These QIs are categorized within six domains of care, including access to care, clinical assessment, medications and medication monitoring, screening for comorbidities, counseling, and self-efficacy and satisfaction with care. Conclusion These QIs have been developed to evaluate and improve the quality of care provided to children with JIA, aiming to enhance health outcomes and ensure that healthcare services are tailored to the unique needs of this patient population.

The biomolecular mechanisms that regulate tooth root development and odontoblast differentiation are poorly understood. We found that Atp6i deficient mice (Atp6i^-/-) arrested tooth root formation, indicated by truncated Hertwig's epithelial root sheath (HERS) progression. Furthermore, Atp6i deficiency significantly reduced the proliferation and differentiation of radicular odontogenic cells responsible for root formation. Atp6i^-/- mice had largely decreased expression of odontoblast differentiation marker gene expression profiles (Col1a1, Nfic, Dspp, and Osx) in the alveolar bone. Atp6i^-/- mice sample RNA-seq analysis results showed decreased expression levels of odontoblast markers. Additionally, there was a significant reduction in Smad2/3 activation, inhibiting transforming growth factor-β (TGF-β) signaling in Atp6i^-/- odontoblasts. Through treating pulp precursor cells with Atp6i^-/- or wild-type OC bone resorption-conditioned medium, we found the latter medium to promote odontoblast differentiation, as shown by increased odontoblast differentiation marker genes expression (Nfic, Dspp, Osx, and Runx2). This increased expression was significantly blocked by anti-TGF-β1 antibody neutralization, whereas odontoblast differentiation and Smad2/3 activation were significantly attenuated by Atp6i^-/- OC conditioned medium. Importantly, ectopic TGF-β1 partially rescued root development and root dentin deposition of Atp6i^-/- mice tooth germs were transplanted under mouse kidney capsules. Collectively, our novel data shows that the prevention of TGF-β1 release from the alveolar bone matrix due to OC dysfunction may lead to osteopetrosis-associated root formation via impaired radicular odontoblast differentiation. As such, this study uncovers TGF-β1 /Smad2/3 as a key signaling pathway regulating odontoblast differentiation and tooth root formation and may contribute to future therapeutic approaches to tooth root regeneration.
Female ; Animals ; Mice ; Transforming Growth Factor beta1 ; Odontoblasts ; Culture Media, Conditioned ; Cell Differentiation ; Signal Transduction ; Disease Models, Animal ; Tooth Root

One new dimeric (1) and two monomeric sesquiterpene lactones (5 and 13), together with 10 known compounds (2-4, 6-12), were isolated from Artemisia heptapotamica collected in Almaty region of Kazakhstan. All compounds were isolated from this plant for the first time. The structures of the new compounds were mainly achieved by extensive analysis of MS, 1D and 2D NMR spectroscopic data, and ECD spectrum as well. The inhibitory activities of all isolates against activation of NF-κB induced by LPS were assessed on a THP1-Dual cell model. Some of them showed strong inhibitory activity with IC values ranging from 2 to 25 μmol·L.

OBJECTIVETo assess the effectiveness and safety of traditional Chinese herbal medicine (TCHM) for chemotherapy-induced leucopenia in patients with malignant tumor.

METHODSChinese database (CNKI, VIP, CBM, Wanfang Database) and English database (Medline, Cochrane Library) were retrieved with the deadline of September 2013. Participants were cancer patients confirmed by pathology waiting for chemotherapy. We included randomized clinical trials (RCTs) testing chemotherapy plus TCHM vs. chemotherapy plus placebo, chemotherapy alone, conventional treatment, or TCHM plus chemotherapy combined with conventional treatment vs chemotherapy combined with conventional treat ment. The primary outcomes were WBC count, leucopenia incidence, and adverse reactions. Assessments of methodological quality, including randomization, allocation, concealment, blindness, dropping-out, loss of follow-ups were also conducted according to the Cochrane Handbook for Systematic Review of Interventions. Meta-analysis was performed using RevMan5. 2 Software provided by Cochrane Collaboration.

RESULTSEighty-seven RCTs (involving 8 468 patients) were included. All these studies were published in Chinese. Of these only two papers were of high quality. Methods of randomization, scheme concealment, blindness, dropping-out, loss of follow-up, samples estimation were not accurately reported in the rest RCTs. The pooled results of WBC count showed that chemotherapy combined with TCHM was generally better than chemotherapy alone [MD =0. 64 x 109/L (0.41, 0.88), P < 0.01]. Auxiliary treatment of Compound Ejiao Syrup, Diyu Shengbai Tablet, Chinese compounds for invigorating Pi and supplementing Shen during the chemotherapeutic course could elevate peripheral blood WBC counts, and decrease the incidence of leucopenia.

CONCLUSIONChinese herbal medicine might have potential effects in preventing the occurrence of leucopenia, which need to be confirmed by launching higher quality clinical trials.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Leukopenia ; chemically induced ; drug therapy ; Medicine, Chinese Traditional ; Neoplasms ; drug therapy ; Phytotherapy ; Randomized Controlled Trials as Topic

OBJECTIVETo explore the efficacy and safety of prostatic arterial embolization (PAE) in the treatment of benign prostatic hyperplasia ( BPH) in high-risk aged males.

METHODSWe retrospectively analyzed the clinical data about 21 high-risk BPH patients aged 77-91 (mean 80) years treated by PAE.

RESULTSPAE was successfully performed in all the 21 patients, with the operation time of 90-120 min. At 2 weeks, 3 months, 6 months, and 12 months after surgery, the International Prostate Symptom Scores (IPSS) were 18.3 ± 3.1, 9.8 ± 2.7, 9.4 ± 2.5, and 10.1 ± 2.2, the quality of life scores ( QOL) were 4.6 ± 1.4, 4.3 ± 1.2, 4.6 ± 1.1, and 4.9 ± 0.6, the maximum urinary flow rates ( Qmax) were (12.5 ± 2.5), (15.8 ± 2.4), (16.6 ± 2.2), and (16.3 ± 1.8) ml/s, and the postvoid residual urine volumes (PVR) were (35.0 ± 3.4), (13.0 ± 3.3), (10.0 ± 3.0), and (8.0 ± 2.5) ml, respectively, markedly improved as compared with the baseline (IPSS: 24.5 ± 3.7, QOL: 5.7 ± 1.6, Qmax: [8.3 ± 2.1] ml/s, and PVR: [98.0 ± 11.0] ml), with statistically significant differences in IPSS, QOL, Qmax, and PVR (all P < 0.05). The maximal velocity of blood flow in the prostate was obviously decreased and the prostate volumes were (74.4 ± 4.8), (42.5 ± 4.4), (38.3 ± 4.0), and (36.7 ± 3.5) cm3 at 2 weeks, 3 months, 6 months, and 12 months, respectively, also significantly reduced in comparison with (84.3 ± 5.4) cm3 preoperatively (all P < 0.05).

CONCLUSIONPAE is a safe and effective option for the treatment of BPH in high-risk aged males.

Aged ; Aged, 80 and over ; Arteries ; Blood Flow Velocity ; Embolization, Therapeutic ; methods ; Humans ; Male ; Prostate ; blood supply ; Prostatic Hyperplasia ; therapy ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Urination

Objective To understand the acute effect of ambient air CO pollution on daily mortality of cerebrocardiovascular diseases among highly and long-term exposed residents of 65 years and over in Taiyuan,Shanxi,China.Methods The relationship of CO concentration and daily mortality of cerebrocardiovascular diseases among residents over 65 years old in Taiyuan(2003-2004) was analyzed by case-crossover design and conditional Logistic regression in SAS 9.0 Results The 48 h accumulated CO concentration had the most significant effect.As increment of CO average was 100 ?g/m~3,the corresponding OR of the effect on the total deaths of the cerebrocardiovascular diseases,the cardiac disease,the ischemic heart disease,myocardial infarction,cardiac failure,arrhythmia and stroke was 1.006,1.010,1.007,1.005,1.005,1.006 and 1.012 respectively.Under different air pollution conditions,the pollutant presented different effects on deaths of eerebrocardiovascular diseases.Conclusion The current CO pollution has caused a certain adverse effect on the cerebrocardiovascular mortality among residents of 65 years and over in Taiyuan city.More stringent measures should be taken to control the air pollution and decrease CO level,thus reduce the mortality of cerebrocardiovascular diseases.

Objective To study the adsorption performance of chitosan in printing and dyeing wastewater treatment.Methods The influence factors such as chitosan concentrations(0-500 mg/L),pH value(1-13),temperatures(20-50 ℃)and time(0.5-2.5 h) were considered in the test.Results When the concentration of chitosan was 200 mg/L,pH value was 2-5,time was 0.5 h and at the room temperature,the absorption could show a good result.The deeolorizing rate could reach above 90%.Conclusion The chitosan concentrations,pH value,time and temperature affect the adsorption performance of chitosan in printing and dyeing wastewater treatment.

Objective To study the effects of 2,2',4,4'-tetrabromodiphenyl ethers(PBDE-47)single exposed and combined with 2,2',4,4',5,5'-hexachlorobiphenyl(PCB153)on learning and memory ability and the uhrastrncture of hippocampal CA1 region in rats.Methods Neonatal SD rats(CL grade)were randomly divided into groups,9 male and 9 female in each,then were exposed to single PBDE-47 at doses of 1,5,10 mg/kg and combined with PCB153 at dose of 5 mg/kg,through gavage for one time. Soya oil was used as the solvent control.The learning and memory ability and ultrastructure of neurons in hippocampal CA1 region were examined respectively 2 months after treatment.Results In the low dose groups(1 mg/kg PBDE-47 and 1 mg/kg PBDE-47+ 5 mg/kg PCB153 treated group),the ultrastructure of neurons in hippocampal CA1 region were as normal as that in the control group.As the dose increasing,in 5 mg/kg PBDE-47 group,the endoplasmic reticulum appeared swelling,expansion and degranulation.In 5 mg/kg PBDE-47 plus 5 mg/kg PCB153 group,the mitochondria appeared swelling,the ridge ruptured,the periplast puffed,and then the cytoplasm condensed.In the high dose groups(10 mg/kg PBDE-47 group and 10 mg/kg PBDE-47 plus 5 mg/kg PCB153 group),the neurons showed acutely denatured,the periplast puffed,the cell organelle dissolved and the mitochondria vacuolizated.The interaction between PBDE-47 and PCB153 on the latency period and the general pathway was presented in place navigation test(P

Objective Through the comparative study of the acute toxic effects of PM2.5 in nickel-contaminated area in rats to explore the possible mechanism of acute toxicity of PM2.5.Methods A nickel-contaminated area and a control area were selected,the air quality of the two areas was monitored and the concentration of nickel in the collected PM2.5 was determined. Forty two male Wistar rats(SPF Grade)were randomly divided into three groups,including one saline control group and two experimental groups,the nickel-polluted group and the non-polluted group,in each.There were three subgroups.PM2.5 were administered to rats by intratraeheal instillation at doses of 1.6 mg/kg,8.0 mg/kg and 40.0 mg/kg respectively.The rats were sacrificed 24 hours after treatment and the brochoalveolar tavage fluid(BALF)were collected,the phagocytic function of alveola macrophages of rats were tested.Results There was no significant difference between the level of environmental quality in the two areas,the concentration of Ni in PM2.5 in the nickel-polluted area was 48.75 times of that in the non-polluted control area.The phagocytic function of alveola macrophages of rats in the experimental groups decreased significantly(P

Objective To investigate the clinical manifestation of bacterial urinary tract infections among old patients with diabetes in recent seven years.Methods In this retrospective study,contrast analysis of clinical features was per- formed on urinary tract infections in old patients between 56 cases with diabetes and 56 cases without it diagnosed during 1998 to 2005.measuring fasting blood glucose,2 hour blood glucose,plasma albumin,24-hour microalbuminuria. Results Incidences of diabetic nephropathy,diabetic retinopathy,neuropathic bladder in observed group are signifi- cantly higher than control group.FBG、2hPBG、24-hour microalbuminuria are significantly higher than control group and plasma albumin is lower than control group.Conclusion The urinary tract infection in old patients with diabetes is associated with fasting blood glucose concentration,complication,gender,disease period and ages,etc.