2.Probiotic supplementation and glomerular filtration rate improvement in chronic kidney disease: A systematic review and meta-analysis
Mark Bennett M. Remora ; Grace D. Juntilla ; Heidii Chua-tan
The Filipino Family Physician 2024;62(2):317-323
BACKGROUND
Chronic kidney disease (CKD) poses a global health threat with significant morbidity and mortality. Despite current therapies, there is a need for innovative interventions to slow CKD progression. Probiotic supplementation shows promise due to its positive effects on gastrointestinal health and inflammation. However, existing research is inconclusive, necessitating a meta-analysis to assess probiotics’ impact on CKD outcomes.
OBJECTIVETo evaluate the existing scientific literature among probiotic supplementation and the improvement in glomerular filtration rate (GFR) among chronic kidney disease (CKD) patients compared to placebo treatment.
METHODSA comprehensive search of electronic databases was conducted to identify relevant studies published up to 2023. Studies that meet the predefined eligibility criteria were included. Data extraction was performed, and methodological quality and risk of bias assessment was conducted for each study. Effect measures, such as mean differences or standardized mean differences, were used to quantify the association between probiotic supplementation and GFR improvement. The random-effects model was applied to estimate the overall effect size, and subgroup analyses were performed to explore potential sources of heterogeneity. Publication bias was assessed, and sensitivity analyses was conducted to evaluate the robustness of the findings.
RESULTSThe meta-analysis encompassed three randomized controlled trials (RCTs) conducted from 2017 to 2023, involving 121 chronic kidney disease (CKD) patients. The analysis focused on the impact of probiotic supplementation on CKD, examining Glomerular Filtration Rate (GFR), Blood Urea Nitrogen (BUN), and Urine Protein Creatinine Ratio (UPCR). While no significant distinctions were found in GFR and BUN changes between probiotics and placebos, there was a statistically significant reduction in UPCR associated with probiotic supplementation in one study. Notably, considerable heterogeneity in GFR and significant heterogeneity in UPCR reduction were observed among the trials. Sensitivity analysis, excluding studies with small sample sizes or high bias risk, remained consistent with overall findings.
CONCLUSIONThe meta-analysis indicated no significant impact of probiotic supplementation on GFR and BUN, but there was a notable reduction in Urine UPCR. The observed heterogeneity among the studies calls for cautious interpretation due to variations in study designs, patient populations, and probiotic formulations. While the results suggest a potential role for probiotics in reducing proteinuria in chronic kidney disease (CKD) patients, the need for further research with larger sample sizes and standardized methodologies is emphasized to establish definitive conclusions.
Human ; Probiotics ; Glomerular Filtration Rate ; Chronic Kidney Diseases ; Renal Insufficiency, Chronic ; Meta-analysis ; Systematic Review
3.Efficacy and mechanism of scalp acupuncture for spastic cerebral palsy.
Chinese Acupuncture & Moxibustion 2023;43(2):163-169
OBJECTIVE:
To observe the clinical efficacy of scalp acupuncture for spastic cerebral palsy (CP), and to explore its possible mechanism based on brain white matter fiber bundles, nerve growth related proteins and inflammatory cytokines.
METHODS:
A total of 90 children with spastic CP were randomly divided into a scalp acupuncture group and a sham scalp acupuncture group, 45 cases in each group. The children in the two groups were treated with conventional comprehensive rehabilitation treatment. The children in the scalp acupuncture group were treated with scalp acupuncture at the parietal temporal anterior oblique line, parietal temporal posterior oblique line on the affected side, and parietal midline. The children in the sham scalp acupuncture group were treated with scalp acupuncture at 1 cun next to the above point lines. The needles were kept for 30 min, once a day, 5 days a week, for 12 weeks. Before and after treatment, the diffusion tensor imaging (DTI) indexes of magnetic resonance (FA values of corticospinal tract [CST], anterior limb of internal capsule [ICAL], posterior limb of internal capsule [ICPL], genu of internal capsule [ICGL], genu of corpus callosum [GCC], body of corpus callosum [BCC] and splenium of corpus callosum [SCC]), serum levels of nerve growth related proteins (neuron-specific enolase [NSE], glial fibrillary acidic protein [GFAP], myelin basic protein [MBP], ubiquitin carboxy terminal hydrolase-L1 [UCH-L1]) and inflammatory cytokines (interleukin 33 [IL-33], tumor necrosis factor α [TNF-α]), cerebral hemodynamic indexes (mean blood flow velocity [Vm], systolic peak flow velocity [Vs] and resistance index [RI], pulsatility index [PI] of cerebral artery), surface electromyography (SEMG) signal indexes (root mean square [RMS] values of rectus femoris, hamstring muscles, gastrocnemius muscles, tibialis anterior muscles), gross motor function measure-88 (GMFM-88) score, modified Ashworth scale (MAS) score, ability of daily living (ADL) score were observed in the two groups. The clinical effect of the two groups was compared.
RESULTS:
After treatment, the FA value of each fiber bundle, Vm, Vs, GMFM-88 scores and ADL scores in the two groups were higher than those before treatment (P<0.05), and the above indexes in the scalp acupuncture group were higher than those in the sham scalp acupuncture group (P<0.05). After treatment, the serum levels of NSE, GFAP, MBP, UCH-L1, IL-33, TNF-α as well as RI, PI, MAS scores and RMS values of each muscle were lower than those before treatment (P<0.05), and the above indexes in the scalp acupuncture group were lower than those in the sham scalp acupuncture group (P<0.05). The total effective rate was 95.6% (43/45) in the scalp acupuncture group, which was higher than 82.2% (37/45) in the sham scalp acupuncture group (P<0.05).
CONCLUSION
Scalp acupuncture could effectively treat spastic CP, improve the cerebral hemodynamics and gross motor function, reduce muscle tension and spasticity, and improve the ability of daily life. The mechanism may be related to repairing the white matter fiber bundles and regulating the levels of nerve growth related proteins and inflammatory cytokines.
Child
;
Humans
;
Cerebral Palsy/therapy*
;
Interleukin-33
;
Diffusion Tensor Imaging/methods*
;
Scalp
;
Muscle Spasticity
;
Tumor Necrosis Factor-alpha
;
Acupuncture Therapy
;
Cytokines
4.Clinical study on application of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.
Hui CHEN ; Xin YAN ; Feng HE ; Sheng Chao DING ; Jin Fu DIAO ; Hui GUO ; Shou Ming CAO ; Chun Juan YANG ; Feng YIN
Chinese Journal of Surgery 2023;61(1):61-65
Objective: To examine the application value of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions. Methods: A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus. Results: All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment. Conclusion: The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
Male
;
Female
;
Humans
;
Child
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Brain Neoplasms/pathology*
;
Diffusion Tensor Imaging
;
Retrospective Studies
;
Robotics
;
Biopsy
;
Software
;
Stereotaxic Techniques
5.Association between Serum Uric Acid and the Early Marker of Kidney Function Decline among Chinese Middle-Aged and Older Population: Evidence from the China Health and Retirement Longitudinal Study.
Xu TANG ; Lu XU ; Ruo Gu MENG ; Yi Qing DU ; Shi Jun LIU ; Si Yan ZHAN ; Tao XU
Biomedical and Environmental Sciences 2023;36(3):231-240
OBJECTIVE:
To evaluate the association between serum uric acid (SUA) and kidney function decline.
METHODS:
Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis. The kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) decrease by > 3 mL/min per 1.73 m 2. Multivariable logistic regression was applied to determine the association between SUA and kidney function decline. The shape of the association was investigated by restricted cubic splines.
RESULTS:
A total of 7,346 participants were included, of which 1,004 individuals (13.67%) developed kidney function decline during the follow-up of 4 years. A significant dose-response relation was recorded between SUA and the kidney function decline ( OR 1.14, 95% CI 1.03-1.27), as the risk of kidney function decline increased by 14% per 1 mg/dL increase in SUA. In the subgroup analyses, such a relation was only recorded among women ( OR 1.22, 95% CI 1.03-1.45), those aged < 60 years ( OR 1.22, 95% CI 1.05-1.42), and those without hypertension and without diabetes ( OR 1.22, 95% CI 1.06-1.41). Although the dose-response relation was not observed in men, the high level of SUA was related to kidney function decline ( OR 1.83, 95% CI 1.05-3.17). The restricted cubic spline analysis indicated that SUA > 5 mg/dL was associated with a significantly higher risk of kidney function decline.
CONCLUSION
The SUA level was associated with kidney function decline. An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
China/epidemiology*
;
East Asian People
;
Glomerular Filtration Rate
;
Kidney/physiopathology*
;
Longitudinal Studies
;
Risk Factors
;
Uric Acid/blood*
6.Advances in bacterial adsorption and transport of aromatic compounds.
Yinming XU ; Huiping REN ; Kai TIAN ; Zhiliang YU ; Qiu MENG
Chinese Journal of Biotechnology 2023;39(3):961-977
Aromatic compounds are a class of organic compounds with benzene ring(s). Aromatic compounds are hardly decomposed due to its stable structure and can be accumulated in the food cycle, posing a great threat to the ecological environment and human health. Bacteria have a strong catabolic ability to degrade various refractory organic contaminants (e.g., polycyclic aromatic hydrocarbons, PAHs). The adsorption and transportation are prerequisites for the catabolism of aromatic compounds by bacteria. While remarkable progress has been made in understanding the metabolism of aromatic compounds in bacterial degraders, the systems responsible for the uptake and transport of aromatic compounds are poorly understood. Here we summarize the effect of cell-surface hydrophobicity, biofilm formation, and bacterial chemotaxis on the bacterial adsorption of aromatic compounds. Besides, the effects of outer membrane transport systems (such as FadL family, TonB-dependent receptors, and OmpW family), and inner membrane transport systems (such as major facilitator superfamily (MFS) transporter and ATP-binding cassette (ABC) transporter) involved in the membrane transport of these compounds are summarized. Moreover, the mechanism of transmembrane transport is also discussed. This review may serve as a reference for the prevention and remediation of aromatic pollutants.
Humans
;
Adsorption
;
Bacteria/metabolism*
;
Organic Chemicals
;
Biological Transport
;
ATP-Binding Cassette Transporters
;
Polycyclic Aromatic Hydrocarbons/metabolism*
7.Preparation of Huoluo Xiaoling gel plaster and its transdermal penetration in vitro.
Li-Hui ZHAO ; Wen ZHANG ; Ruo-Ying FAN ; Shu-Lan SU ; Er-Xin SHANG ; Da-Wei QIAN ; Jin-Ao DUAN
China Journal of Chinese Materia Medica 2023;48(5):1238-1248
Huoluo Xiaoling Dan is a classical prescription commonly used for blood circulation and pain relief in clinic with obvious effects. To make it directly treat lesion and improve the effect, this research optimized the preparation process of Huoluo Xiaoling gel paste and further evaluated its in vitro transdermal absorption performance, so as to provide a scientific basis for its development and utilization. Using primary viscosity, holding viscosity, and sensory score as evaluation indexes, the matrix amount of gel paste was determined by the single factor test and Box-Behnken response surface method. The ultra-performance liquid chromatography(UPLC) method was established to determine the content of eight active ingredients, including Danshensu, ferulic acid, salvianolic acid B, salvianolic acid A, ligustilide, tanshinone Ⅱ_A, 11-keto-β-boswellic(KBA), and 3-acetyl-11-keto-β-boswellic acid(AKBA). A mo-dified Franz diffusion cell method was used to evaluate and compare the absorption properties of the gel paste without volatile oil and with volatile oil microemulsion. The results showed that the optimal prescription for Huoluo Xiaoling gel paste matrix was NP700(1.35 g), glycerol(7.00 g), micropowder silica gel(1.25 g), sodium carboxymethyl cellulose(0.20 g), tartaric acid(0.06 g), and glyceryl aluminum(0.04 g). The mass fractions of eight active ingredients in the paste were successively 0.48, 0.014, 0.95, 0.39, 0.57, 0.055, 0.35, and 0.97 mg·g~(-1). The results of the in vitro transdermal absorption test showed that the addition of the volatile oil or the volatile oil microemulsion promoted the transdermal absorption of the active ingredients, and the law of drug penetration conformed to the zero equation or the Higuchi equation. The gel paste prepared by the optimal prescription has good appearance and adhesion, with no residue, and has the characteristics of skeletal slow-release preparation, which is easy to reduce the number of administration, la-ying a foundation for the development of new external dosage forms of Huoluo Xiaoling Dan.
Administration, Cutaneous
;
Skin Absorption
;
Chromatography, Liquid
;
Oils, Volatile
;
Viscosity
8.Research progress on head imaging features of carbon monoxide poisoning and delayed encephalopathy.
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(1):57-62
Acute carbon monoxide poisoning and its delayed encephalopathy have obvious damage to the central nervous system. There are different neuroimaging changes in different stages of the disease, and they are relatively specific. This article reviews the clinical research progress on the imaging changes of carbon monoxide poisoning and delayed encephalopathy, including computed tomography (CT) , conventional magnetic resonance imaging (MRI) , diffusion weighted imaging (DWI) , diffusion tensor imaging (DTI) , diffusion kurtosis imaging (DKI) , magnetic resonance spectroscopy (MRS) and other imaging changes reflecting the function and metabolic state of the brain tissue.
Humans
;
Brain Diseases/etiology*
;
Carbon Monoxide Poisoning/diagnostic imaging*
;
Diffusion Magnetic Resonance Imaging
;
Diffusion Tensor Imaging
;
Magnetic Resonance Imaging
;
Tomography, X-Ray Computed
;
Magnetic Resonance Spectroscopy
9.Expression profile of microRNA secreted by rat condylar chondrocytes under tensile stress.
Yuan SHI ; Jia Qi SHAO ; Jia Nan ZHANG ; Zan Zan ZHANG ; Hai Ping LU
Chinese Journal of Stomatology 2023;58(1):57-63
Objective: To preliminarily explore the mechanism of tensile stress regulating endochondral osteogenesis of condyle by analyzing the expression profiles of significantly different microRNAs (miRNAs) in exosomes of rat mandibular condylar chondrocytes (MCC) under quiescent and cyclic tensile strain (CTS) conditions. Methods: Rat condylar chondrocytes were cultured under static and CTS conditions respectively (10 SD rats, male, 2 weeks old), and exosomes were extracted. The two groups of exosomes were named as control group and CTS group respectively. The differential expression miRNAs were screened by high-throughput sequencing. Bioinformatics analysis and prediction of target genes related to osteogenesis were performed by TargetScan and miRanda website. Results: The exosomes of rat condylar chondrocytes cultured under tensile stress showed a "double concave disc" monolayer membrane structure, the expression of CD9 and CD81 were positive, and the particle size distribution accorded with the characteristics of exosomes, which was consistent with that of static cultured rat condylar chondrocytes. A total of 85 miRNAs with significantly different expression were detected by high-throughput sequencing (P<0.05). The main biological processes and molecular functions of differential miRNAs were biological processes and protein binding, respectively. Kyoto Encyclopedia of Genes and Genomes (KEGG) database pathway enrichment analysis showed that there was significant enrichment in mammalian target of rapamycin (mTOR) signal pathway. The candidate target genes of miR-199a-5p include bone morphogenetic protein 3 (BMP3), endothelin converting enzyme 1, and miR-186-5p may target Smad8 and BMP3 to exert osteogenesis-related functions. Conclusions: Compared with static state, tensile stress stimulation can change the expression of miRNAs such as miR-199a-5p, miR-186-5p in the exocrine body of rat condylar chondrocytes, which can be considered as a mean to regulate the application potential of the exosomes.
Animals
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Male
;
Rats
;
Bone Morphogenetic Protein 3
;
Chondrocytes/metabolism*
;
Mandibular Condyle
;
MicroRNAs/metabolism*
;
Rats, Sprague-Dawley
;
Signal Transduction
;
Stress, Mechanical
10.Advances on pathogenesis of acquired peritoneal ultrafiltration failure in peritoneal dialysis.
Na JIANG ; Wei Zhen XIE ; Le Yi GU ; Zhao Hui NI ; Wei FANG ; Jiang Zi YUAN
Chinese Journal of Hepatology 2023;39(1):42-47
Peritoneal ultrafiltration failure is a common reason for peritoneal dialysis (PD) withdrawal as well as mortality in PD patients. Based on the three-pore system, inter-cellular small pores and trans-cellular ultra-small pores (aquaporin-1) are mainly responsible for water transfer across the peritoneum. Both small and ultra-small pores-dependent water (free water) transport decline accompanied with time on PD, with more significant decrease in free water, resulting in peritoneal ultrafiltration failure. The reduction of free water transport is associated with fast peritoneal solute transfer, reduced crystalloid osmotic gradient due to increased interstitial glucose absorption, and declined osmotic conductance to glucose resulted from impaired aquaporin-1 function and peritoneal interstitial fibrosis. The decline of small pore-based water is mainly because of fast loss of crystalloid osmotic gradient, decrease of hydrostatic pressure mediated by peritoneal vasculopathy, as well as reduced absolute number of small pores. The current review discusses the advance on pathogenesis of acquired peritoneal ultrafiltration failure in long-term PD.
Humans
;
Peritoneum
;
Ultrafiltration
;
Dialysis Solutions
;
Peritoneal Dialysis/methods*
;
Water
;
Glucose


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