GEN Group Research Articles

P-927. Clinical Outcome of Ampicillin plus Ceftriaxone Compared to Nafcillin or Cefazolin plus Gentamicin as an Empirical Treatment for Infective Endocarditis

Abstract Background A combination of anti-staphylococcal penicillin or cefazolin and gentamicin has been recommended as an empirical treatment regimen for native valve or late prosthetic valve infective endocarditis (NV/LPVIE), while the recent European Society of Cardiology Guidelines proposed ampicillin plus ceftriaxone (AMP+CRO) as an empirical option. However, clinical data supporting either regimen are scarce. Risk factors of composite outcome in a Cox proportional hazard model with overlap weighting. Methods A retrospective cohort study was conducted in a large tertiary care hospital. Adults aged ≥18 years who were diagnosed with NV/LPVIE by the modified Duke criteria from 2000 through 2022 were included. Patients were grouped by empirical antibiotic regimens including AMP+CRO versus nafcillin or cefazolin plus gentamicin (NAF/CFZ+GEN). Multiple logistic regression with overlap weighting was used to compare outcome between the two groups. Primary outcome was all-cause mortality or relapse within 6 months since diagnosis. Survival probabilities by empirical treatment regimen. (A) Observed survival without relapse, (B) probability of survival without relapse in the Cox proportional hazard model with overlap weighting. Results A total of 172 patients were included and divided into two groups by the empirical antibiotic regimens of AMP+CRO (n=102) or NAF/CFZ+GEN (n=70). Both groups exhibited similar baseline characteristics, including underlying diseases, preexisting valvular conditions, and involved valves. However, diabetes, cardiovascular diseases, and congestive heart failure were more common in the AMP+CRP group. Viridans group Streptococcus was the most frequently identified pathogen (33.3%) who were administered AMP+CRP, while Staphylococcus aureus was the most prevalent pathogen in the NAF/CFZ+GEN group (42.9%). In the AMP+CRO group, 6 (5.9%) met the composite outcome compared with 6 (8.6%) in the NAF/CFZ+GEN group (P = 0.551). There was also no statistically significant difference in the risk of composite outcome between the two groups in a multivariable analysis with overlap weighting (adjusted odds ratio, 0.27; 95% confidence interval, 0.05–1.43; P = 0.125). Factors associated with initial treatment with ampicillin + ceftriaxone in a logistic regression model Conclusion In the patients with NV/LPVIE, AMP+CRO as empirical antibiotic therapy showed no significant difference in the all-cause mortality or relapse within 6 months since diagnosis compared to NAF/CFZ+GEN. Our results suggest that AMP+CRO can be used as a primary empirical regimen for the treatment of NV/LPVIE. Covariate balance before and after overlap weighting Disclosures All Authors: No reported disclosures

Sonification of Deproteinized Bovine Bone Functionalized with Genistein Enhances Bone Repair in Peri-Implant Bone Defects in Ovariectomized Rats.

Estrogen deficiency is one of several contributing factors to catabolic changes in bone surrounding dental implants, impairing bone repair in defects requiring bone regeneration. Functionalizing bone substitutes is an alternative approach among various strategies to address this challenge. In this study, the aim was to evaluate the effect of functionalizing deproteinized bovine bone (Bio-Oss®, BO) with genistein via sonication on peri-implant bone defects in ovariectomized rats. The animals were randomly distributed according to the treatment into the following four groups (n = 10): BO sonicated with genistein (BOS + GEN), BO sonicated alone (BOS), untreated BO (BO), and blood clot only (CLOT). After twenty-eight days, implant removal torque was determined, and the peri-implant bone parameters were calculated based on computed microtomography. Additionally, the gene expression of bone turnover markers was evaluated. As a main result, the functionalization with genistein increased implant removal torque and the peri-implant bone volume in the BOS + GEN group compared to both BOS and BO groups (both p < 0.05). These findings suggest that the sonification of deproteinized bovine bone functionalized with genistein improves bone repair in peri-implant bone defects in ovariectomized rats.

Effectiveness of setarud (IMOD™) in attenuating gentamicin-induced nephrotoxicity in male rats

BackgroundGentamicin (GEN) can have serious adverse effects including nephrotoxicity. Setarud (IMOD™) is a new herbal drug with beneficial immune effects, obtained by mixing Tanacetum vulgare (tansy), Rosa canina and Urtica dioica (nettle) extracts as well as selenium, flavonoids and carotenes. This novel study aims to evaluate the effectiveness of Setarud (IMOD™) in attenuating GEN-induced nephrotoxicity in male rats. Twenty-eight adult male Sprague Dawley rats (weighing 180–200 g) were randomly divided into four groups (7 rats in each group): Control, IMOD treated (20 mg/kg body weight), GEN treated (100 mg/kg body weight), and GEN + IMOD co-treated. Injections were done intraperitoneally for 12 days. Serum urea, creatinine (Cr), Cr clearance, malondialdehyde (MDA), reduced glutathione (GSH) level, and activities of antioxidant enzymes Peroxidase (POD), Catalase (CAT), and Glutathione peroxidase (GPx) were measured by the colorimetric method. Volume density of proximal convoluted tubule (PCT), tubular necrosis, tubular cast formation, and leukocytic infiltration were evaluated histopathologically.ResultsIn the GEN group, there were significantly higher serum urea, Cr, and MDA levels with lower Cr clearance, GSH levels, POD, GPx and CAT activities, and PCT volume density with presence of tubular necrosis compared to the control and IMOD groups (P < 0.05). Treatment with IMOD significantly reduced the levels of urea, Cr and MDA, and increased Cr clearance and the activities of POD and CAT enzymes (P < 0.05). No significant differences in the activity of GSH and GPx were reported in the GEN + IMOD co-treated group compared to the GEN group. Moreover, IMOD significantly ameliorated PCT volume density and renal lesions caused by GEN.ConclusionIMOD (20 mg/kg body weight) can attenuate GEN-induced nephrotoxicity in rats by inhibition of oxidative stress or increasing the normal activity of antioxidant enzymes. Further studies are recommended on the effects of different doses of IMOD.

Molecular, enzymatic responses and in vitro embryonic developmental competency of heat-shocked buffalo embryos co-cultured with granulosa cells monolayer

The present study was designed to establish a suitable alternative approach to mitigate the adverse effect of high culture temperature on in vitro embryo development and the related molecular response in buffalo. Pre-cultured granulosa cells (GCs) were used as a monolayer during in vitro embryo culture until day 8 (day of fertilization = D0). Post fertilization, presumptive embryos were randomly assigned into two culture conditions: embryos cultured in the presence of GCs monolayer under normal culture temperature (N: 38.5 °C; GEN group) or heat shock (H: 40.5 °C; GEH group) and their counterpart groups of embryos cultured without GCs (EN and EH groups). Additionally, two groups of GCs monolayer were cultured without embryos up to day 8 under 38.5 °C (GN) or 40.5 °C (GH) for further spent culture media enzymatic analyses. Heat shock was administered for the first 2 h of culture then continued at 38.5 °C until day 8. The results indicated that under heat treatment, GCs enhanced (P ≤ 0.05) embryo cleavage and development (day 8) rates, which were comparable to the embryos cultured at 38.5 °C. On the molecular level, blastocysts of the GEH group showed similar expressions of metabolism-regulating genes (CPT2 and SlC2A1/GLUT1) and an antioxidant gene (SOD2) when compared to the blastocysts of the EN group. The relative expression of HSP90 was significantly up-regulated under heat shock and/or co-culture conditions. However, HSF1 expression was increased (P ≤ 0.05) in the GEH group. No statistical differences were observed among the study groups for the pluripotency gene NANOG, and stress resistance transcript NFE2L2. Regarding the enzymatic profile, the concentrations of SOD, total protein, and MDA were decreased (P ≤ 0.05) in the GEH group compared to the cultured GCs without embryos (GH group). In conclusion, GCs as a monolayer have a beneficial impact on alleviating heat stress at the zygote stage through the regulatory mechanisms of metabolic activity, defense system, and heat shock response genes.

Missed Opportunities for Urate Lowering Therapy after Gout Flares in Frail Patients Living Alone

Background/Aims: Irrespective of socioeconomic status, urate lowering therapy (ULT) is crucial for all chronic gout patients. We investigated the presence of missed opportunities for ULT among underprivileged patients treated at a major public hospital in Korea after a severe gout flare.Methods: We first collected information on patients admitted under the diagnosis of gout (International Classification of Diseases 10th Revision code M10) at a major public hospital from March 2011 to February 2022. De-identified patient data, including sociodemographic status, uric acid levels, list of medications, and outpatient follow-up data, were extracted. The patients were grouped into frail patients, who were living alone and were admitted to the specialized ward (SPE), and those who were admitted to the general ward (GEN). Primary endpoints were the outpatient visit rate immediately after discharge and the rate of ULT maintenance after a year.Results: Acute gouty arthritis was the chief event during admission in 136 cases. The mean (± standard deviation) age was 60.1 (± 16.1) years, and 95% of the patients were male. Only 18% of the patients were on ULT before admission. The patients were divided into the SPE (n = 25) and GEN (n = 111) groups. Body mass index in the SPE group was lower than in the GEN group (23.4 [± 4.4] and 25.1 [± 3.7], respectively, &lt;i&gt;p&lt;/i&gt; = 0.082). The uric acid levels at admissio in the SPE and GEN groups were 9.6 (± 2.7) and 7.6 (± 2.3), respectively (&lt;i&gt;p&lt;/i&gt; = 0.0023). After discharge, 80% and 95.5% of the SPE and GEN group participants presented to the outpatient department within 1 month, respectively (&lt;i&gt;p&lt;/i&gt; = 0.019). ULT was continued or initiated in 85% of the patients. However, fewer patients continued colchicine for at least 3 months in the SPE group compared to the GEN group (25.0% and 43.4%, respectively). After 1 year, the SPE group had a higher rate of loss to follow-up (32.0% vs. 23.4%), higher uric acid levels (7.4 [± 3.8] vs. 6.2 [± 2.1]), and fewer ULT users (41.2% vs. 50.6%) compared to the GEN group, but the differences were not statistically significant.Conclusions: Frail patients who lived alone, even in the metropolitan area, missed opportunities for ULT and long-term gout care. Joint efforts on the part of health authorities and social workers are necessary to devise a strategy for better access and management among underprivileged gout patients.

Genistein acts in bone metabolism and improves peri-implant healing in rats with estrogen deficiency

The present study aimed to evaluate the peri-implantar bone healing in the presence of genistein treatment in ovariectomized rats. Thirty female rats with 4 months old were divided into 3 groups according to the experimental condition and the drug treatment: SHAM (rats submitted to the fictional surgery and gavage with 0.9% saline solution); OVX (rats submitted to bilateral ovariectomy and gavage with 0.9% saline solution); OVX GEN (rats submitted to bilateral ovariectomy and gavage with 1mg/day of genistein). 60 implants were installed, with two implants in each animal. The calcified group was subjected microcomputerized tomography and the parameters analysed was bone volume per tissue volume (BV/TV) and connective density (Cnn.Dn). The decalcified samples were evaluated through immunolabeling analysis, in order to detect the presence of RUNX2, Alkaline Phosphatase, Osteocalcin, Osteopontin and TRAP. All the quantitative data were submitted to the normality curve to determine the most adequate test. The significance level of p&lt;0.05 was considered for all tests. The morphometric analysis of the OVX GEN group showed higher percentage of bone volume and lower connective density when compared with OVX. Immunohistochemical analysis favors expression. For the markers that positively label osteoblastic activity. This study shows that genistein therapy improves peri-implant bone healing in ovariectomized rats.

Ultrasound Guided Paravertebral Nerve Block in Thoracotomy

The pain after thoracic surgery is often moderate to severe. Perioperative analgesia has always been one of the research hotspots of thoracic anesthesia. The patients were prepared before operation according to the routine, and the fasting time was performed according to the fasting guidelines before anesthesia for adult surgery. After entering the operating room, first establish an infusion channel in the vein of the upper limb, and routinely use a monitor to monitor the basic vital signs. Puncture the right internal jugular vein and place the tube under ultrasound; Under local anesthesia, the radial artery was punctured and catheterized, and the catheter was connected with the transducer to monitor the invasive blood pressure. All patients in group P used the puncture method through the lateral approach. Use the same method on the opposite side. The plane was measured by acupuncture. If there was hypoesthesia, the effect of block was determined, and the spinal nerve block segments after plane fixation were recorded. The complications related to puncture (such as pneumothorax, hemothorax, local anesthetic poisoning, etc.), operation time, extubation time, propofol, remifentanil and the use of cisatracurium during maintenance were recorded. Among all patients, the patients with ID ≥ 2 in TPVB group and Gen group were 14.1% and 18.8% respectively, and the difference was not statistically significant (P > 0.05). Thoracic paravertebral block combined with general anesthesia is beneficial to reduce perioperative complications, incidence rate and mortality, and improve postoperative outcome.

Strategic and Organizational Change

Strategic and Organizational Change

DOES TOPICAL USE OF GENTAMICIN REDUCE THE INFECTION RATE IN PRIMARY TOTAL HIP ARTHROPLASTY?

ABSTRACTObjective:To determine whether the topical use of gentamicin reduces periprosthetic joint infection rates in primary total hip arthroplasty (THA).Methods:We retrospectively evaluated two cohorts of patients who underwent primary THA in a university hospital, with a minimum of 1-year postoperative follow-up and full clinical, laboratory, and radiological documentation. Patients who underwent operation in the first 59 months of the study period (263 hips) received only intravenous cefazolin as antibiotic prophylaxis (Cef group), and those who underwent operation in the following 43 months (170 hips) received intravenous cefazolin plus topical gentamicin directly applied on the wound as antibiotic prophylaxis (Cef + Gen group). For the diagnosis of periprosthetic joint infection, we used the criteria of the Centers for Disease Control and Prevention. Data were analyzed using the Fisher exact test, and p values of <0.05 were considered significant.Results:Thirteen hips (4.9%) in the Cef group and eight hips (4.7%) in the Cef + Gen group presented periprosthetic joint infection. Statistical analysis revealed no difference between the infection rates (p = 1.0).Conclusion:Topical gentamicin as used in this study did not reduce periprosthetic joint infection rates in primary THA. Level of Evidence III, Retrospective comparative study.

Influence of Zingiber officinale Extract on Push-Out Bond Strength of Glass-Fiber Post.

The aim of this study was to evaluate in vitro the influence of 20% glycolic ginger extract on the bond strength of glass-fiber post cemented with etch-and-rinse or self-etching resin cement. Forty-eight bovine roots were standardized (17±0.5 mm) and randomly divided into two groups, according to irrigant used during biomechanical preparation: NaOCl: 1% sodium hypochlorite and GEN: 20% glycolic ginger extract. Root canal was prepared and randomly assigned to one of two subgroups (n=12), according to luting protocol: self-etching (RelyX U200) and etch-and-rinse (RelyX ARC). After 48 h, the roots were sectioned perpendicularly (4 in cervical third and 3 in middle third) and submitted to push-out bond strength test (50 kgf load cell, 1.0 mm/min). Failure mode was analyzed in SEM and stereomicroscopy. Data were analyzed by three-way ANOVA and Tukey tests (p<0.05). ANOVA revealed that there were no significant differences between U200 (2.01±0.17)B and ARC (1.93±0.12)B in GEN group, and at the cervical third for both irrigants, 2.69±0.16A and 2.54±0.17A, respectively. Middle third showed lower bond strength than cervical third, regardless the irrigant. Overall, the cervical third regardless the irrigant employed and the association between NaOCl and ARC, presented better adhesive performance.

Protective Effects of Geniposide on Hepatic Ischemia/Reperfusion Injury

BackgroundGeniposide (GEN) is the major ingredient of Gardenia jasminoides Ellis, which has anti-inflammatory and anti-apoptotic activities and is widely used to treat ischemia disease. Inflammation and apoptosis play an important role in hepatic ischemia/reperfusion (I/R) injury. The current study was conducted to explore the effects of geniposide on hepatic I/R injury and its potential molecular mechanism in mice. MethodsFifty Sprague-Dawley rats were randomly divided into 5 groups: the sham group (sham), the hepatic I/R injury group (IRI) and the GEN groups (low, middle, and high). In the GEN and IRI groups, hepatic IRI by was induced by means of clamping the left and median liver lobes for 30 minutes with noninvasive endoclips. The GEN groups were pretreated with GEN (5, 10, 20 mg/kg) at 30 minutes before ischemia by use of intraperitoneal injection. Rats in the IRI group and sham group were administrated with same dosage of saline at the same time. After reperfusion for 6 hours, the hepatic pathology and the expression of alanine aminotransferase (ALT), AST aspartate aminotransferase, LDH lactic acid dehydrogenase, PI3K, AKT, p-AKT, m-TOR, Bax, BCL-2, interleukin (IL)-6, MCP-1, and tumor necrosis factor (TNF)-α were examined. ResultsCompared with the sham group, the IRI group had higher expression of ALT, AST, LDH, Bax, IL-6, MCP-1, and TNF-α and lower expression of BCL-2, PI3K, p-AKT, and mammalian target of rapamycin (mTOR), with more inflammatory cell infiltration, cellular swelling, and vacuolar degeneration. Compared with the IRI group, the GEN group had lower expression of ALT, AST, LDH, Bax, IL-6, MCP-1, and TNF-α and higher expression of BCL-2, PI3K, p-AKT, and mTOR, with less inflammatory cell infiltration, cellular swelling, and vacuolar degeneration. There were no differences in the expression of AKT among several groups. ConclusionsGEN can protect rats against hepatic I/R injury and partly relies on suppressing inflammation and apoptosis by inducing the activation of the PI3K/Akt/mTOR signaling pathway.

Pre-operative lumbar plexus block provides superior post-operative analgesia when compared with fascia iliaca block or general anesthesia alone in hip arthroscopy.

The objective of this study is to retrospectively examine the effects of pre-operative fascia iliaca (FI) and lumbar plexus (LPB) nerve blocks on post-operative pain and secondary post-operative variables following arthroscopic surgery of the hip. Subjects undergoing arthroscopic surgery of the hip received one of three pre-operative anesthetic techniques; general anesthesia only, general anesthesia with FI or general anesthesia with LPB. Patient reported pain scores (0–10) were recorded at 0, 30, 60, 90 and 120 min after admission to the post-anesthesia care unit (PACU). Secondary variables examined include time spent in the PACU, morphine equivalent administered, presence of nausea, persistent numbness, parasthesia, weakness, increased narcotic usage for rebound pain, ED visits and hospital admissions. The mean pain scores over all time points were significantly lower in the LPB group (2.38) than the FI group (4.08, P < 0.001) and the Gen group (3.55, P < 0.001). Patients receiving a lumbar plexus block exhibited significantly decreased pain at t = 0 (P = 0.019), t = 30 (P = 0.038), t = 60 (P = 0.013), t = 90 (P = 0.017) and t = 120 (P = 0.001) after admission to PACU. The FI group showed no improvement in any post-operative variable when compared with general anesthesia alone. There was no difference in the time to discharge or in morphine equivalent administered between groups. One patient receiving a lumbar plexus block experienced a seizure lasting about 10 s. However, there were no medium or long-term complications. Lumbar plexus block administered in concert with general anesthesia provides clinically important and statistically significant post-operative pain relief when compared with general anesthesia alone or general anesthesia plus fascia iliaca block.

Dietary Genistein Prevents Denervation-Induced Muscle Atrophy in Male Rodents via Effects on Estrogen Receptor-α

Background: Genistein has high estrogenic activity. Previous studies have shown beneficial effects of estrogen or hormone replacement therapy on muscle mass and muscle atrophy.Objective: We investigated the preventive effects and underlying mechanisms of genistein on muscle atrophy.Methods: In Expt. 1, male Wistar rats were fed a diet containing no genistein [control (CON)] or 0.05% genistein (GEN; wt:wt diet) for 24 d. On day 14, the sciatic nerve in the left hind leg was severed, and the right hind leg was sham-treated. In Expt. 2, male C57BL6J mice were subcutaneously administered a vehicle (Veh group) or the estrogen receptor (ER) antagonist ICI 182,780 (ICI group) via an osmotic pump for 27 d, and each group was subsequently fed CON or GEN diets from day 3 to day 27. Muscle atrophy was induced on day 17 as in Expt. 1. In Expt. 3, male C57BL6J mice were subcutaneously administered vehicle or a selective ER agonist—ER-α [4,4′,4′-(4-propyl-[1H]-pyrazole-1,3,5-triyl)trisphenol (PPT)] or ER-β [2,3-bis(4-hydroxyphenyl)-propionitrile (DPN)]—or genistein (GEN-sc-i) via an osmotic pump for 13 d, and muscle atrophy was induced on day 3 as in Expt. 1. The ratio of denervated soleus muscle weight to sham-operated soleus muscle weight (d/s ratio) was used as the index of muscle atrophy.Results: Expt. 1: The d/s ratio in the GEN group was 20% higher than that in the CON group (P < 0.05). Expt. 2: The d/s ratio in the Veh-GEN group was 14% higher than that in the Veh-CON group (P < 0.05), although there was no significant difference between ICI-CON and ICI-GEN groups (P = 0.69). Expt. 3: The d/s ratio in the PPT-treated group was 20% greater than that in the Veh group (P < 0.05), but DPN and GEN-sc-i had no effect on the d/s ratio (P ≥ 0.05 compared with vehicle).Conclusion: Genistein intake mitigated denervation-induced soleus muscle atrophy. ER-α was related to the preventive effect of genistein on muscle atrophy.

Therapeutic effect of oregano essential oil on subclinical bovine mastitis caused by Staphylococcus aureus and Escherichia coli

Oregano (Origanum vulgare) is an aromatic herb belonging to the Lamiaceae family. This study evaluated the therapeutic effect of oregano essential oil (OEO) on clinical bovine mastitis caused by Staphylococcus (S.) aureus and/or Escherichia (E.) coli. Thirty-two quarters from 18 lactating cows with subclinical mastitis were selected from a dairy farm and were divided into 4 groups (8 quarters/group): negative control (CON), positive control (GEN) and two OEO-treated groups (OEO-1 and OEO-2). Each group was intramammarily treated with saline, 10 g/tube of gentamicin ointment, and single and double doses of 0.9 mL OEO ointment twice a day for three days, respectively. After the treatments, physical udder conditions were greatly improved in GEN and OEO groups. In CON group, somatic cell counts (SCCs), number of white blood cells (WBC) and bacteria were increased. However, in OEO groups, SCCs and number of WBC were significantly decreased and S. aureus and E. coli were not detected in milk as compared with those before the treatments as well as GEN group. These results suggest that OEO may be a useful alternative to antibiotics for the control of subclinical bovine mastitis caused by S. aureus and/or E. coli.

Protective effect of hydrogen sulfide on gentamicin-induced renal injury

Objective: We evaluated the potential protective effect of hydrogen sulfide (H2S) against GEN-induced nephrotoxicity in rats. Materials and methods: Twenty-four rats were randomly divided into four groups, each consisting of six animals as follows: (1) the rats were control, (2) intraperitoneally injected with GEN 14 consecutive days (100 mg/kg/day), (3) treated with GEN plus %0.9 saline intraperitoneally for 14 days and (4) treated with GEN plus sodium hydrogen sulfide (NaHS)-exogenous H2S donor (56 µmol/kg/day) for 14 days. After 15 days, rats were sacrificed and their kidneys were taken and blood analysis was performed. Twenty-four hours urine collections were obtained in standard metabolic cages a day before the rats were sacrificed. Tubular necrosis and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH) levels were determined in the other part of kidneys. Statistical analyses were made by the chi-squared test and one-way analysis of variance. Results: Serum urea and creatinine levels were significantly higher in rats treated with GEN alone, than the rats in control and GEN + NaHS groups. The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of NaHS to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and NaHS had significantly lower MDA and NO levels in kidney cortex tissue than those that was given GEN alone. In rats treated with GEN + NaHS, despite the presence of mild tubular degeneration and tubular necrosis are less severe, and glomeruli maintained a better morphology when compared with GEN group. Discussion: We can say that H2S prevent kidney damage with antioxidant and anti-inflammatory effect.

Postoperative early enteral nutrition therapy with long peptide mixture for gastric cancer patients：a clinical control study

Objective To study the efficacy of postoperative early enteral nutrition(EN)therapy with long peptide mixture in gastric cancer patients receiving distal subtotal gastrectomy.Methods A total of 70patients with gastric cancer were randomly divided into experimental group(n=35)and control group(n=35)after distal subtotal gastrectomy.The experimental group received early enteral nutrition with long peptide mixture postoperatively(NEN group)and the control group received early enteral nutrition with glucose saline postoperatively(GEN group).Results There were no significant differences in the recovery time of intestinal peristalsis or ventilation time between the two groups after treatment.Significant differences were found between the two groups regarding the symptoms of diarrhea and vomiting(P=0.048,P=0.000).The hospitalization time and total cost of hospitalization were not significantly different between the two groups.The level of prealbumin in the experimental group was significantly higher than those in the control group on the fourth and seventh days after operation(P=0.000,P=0.000);moreover,compared with the control group,the experimental group had significantly higher IgGlevel on the fourth day and seventh day after operation(P=0.000 6,P=0.000 8),and IgM level was significantly higher than that in the control group on the seventh day after operation(P=0.000 1).Conclusion Postoperative early enteral nutrition with long peptide mixture can induce obvious gastrointestinal irritation symptoms in gastric cancer patients receiving distal subtotal gastrectomy,but it does not greatly increase the hospitalization time or cost,and can rapidly improve the nutrition and immune state of patients.

Gentamicin-enriched, water-soluble polymer wax reduces the burden of infection after sternotomy in pigs

One of the most frequent complications in cardiac surgery is postoperative bleeding from the sternum. To diminish the risk of bleeding, bone wax is frequently used for haemostasis. However, we have previously shown that bone wax impairs bone healing and induces inflammation in the sternum. A new, water-soluble polymer wax enriched with gentamicin has haemostatic properties similar to bone wax and may diminish the risk of infection. The purpose of this study was to determine whether the gentamicin-enriched, water-soluble polymer wax could reduce infection rates when compared with bone wax in a porcine model. Thirty-two Landrace/Yorkshire pigs were sternotomized and randomized to haemostasis by gentamicin-enriched, water-soluble polymer wax (Gen group) or bone wax (Wax group). After 4 weeks the pigs were euthanized. Blood samples were analysed for the fraction and concentration of neutrophil granulocytes and C-reactive protein and the surgical site was biopsied. Stereology was performed on histological samples, and the magnitude of infection was quantified as the areas of microabscesses, granulomas and tissue with acute inflammation compared with the total tissue area. The temperature was 38.2 °C in the Gen group vs 38.6 °C in the Wax group, P < 0.05. No animals in the Gen group and three in the Wax group showed a temperature >39.3 °C. Neutrophil granulocyte concentration was 5.00 × 10(9)/l in the Gen group and 6.92 × 10(9)/l in the Wax group, P = 0.277, with a leucocyte fraction of 20.9% vs 29.3%, P = 0.119. C-reactive protein (CRP) was 142 mg/l in the Gen group compared with 318 mg/l in the Wax group, P = 0.106. Histological samples showed acute inflammatory changes in 5.0% of the tissue in the Gen group vs 18.3% in the Wax group, P < 0.001. Microabscesses were present in 0.3% of the sample tissue in the Gen group vs 2.2% in the Wax group, P < 0.001. Concentrations of gentamicin were >100 mg/l in mediastinal fluid and <2 mg/l in venous blood. When used for haemostasis after sternotomy in a porcine model, gentamicin-enriched, water-soluble polymer wax reduces sign of infection when compared with bone wax and therefore appears to be a more suitable choice for preventing postoperative, sternal osteomyelitis.

Injured kidney endothelium is only marginally repopulated by cells of extrarenal origin

The role of bone marrow marrow-derived cells after kidney endothelial injury is controversial. In this study, we investigated if and to what extent extrarenal cells incorporate into kidney endothelium after acute as well as during chronic endothelial injury. Fischer F-344wt (wild type) rat kidney grafts were transplanted into R26-hPAP (human placental alkaline phosphatase) transgenic Fischer F-344 recipient rats to allow identification of extrarenal cells by specific antibody staining. A severe model of renal thrombotic microangiopathy was induced via graft perfusion with antiglomerular endothelial cell (GEN) antibody and resulted in eradication of 85% of the glomerular and 69% of the peritubular endothelium (GEN group). At week 4 after injury, renal endothelial healing as well as recovery of the kidney function was seen. Endothelial chimerism was evaluated by double staining for hPAP and endothelial markers RECA-1 or JG-12. Just 0.25% of the glomerular and 0.1% of the peritubular endothelium was recipient derived. In a second experiment, chronic endothelial injury was induced by combination of kidney transplantation with 5/6 nephrectomy (5/6 Nx group). After 14 wk, only 0.86% of the peritubular and 0.05% of the glomerular endothelium was of recipient origin. In summary, despite demonstration of extensive damage and loss as well as excellent regeneration, just a minority of extrarenal cells were incorporated into kidney endothelium in rat models of acute and chronic renal endothelial cell injury. Our results highlight that kidney endothelial regeneration after specific and severe injury is almost exclusively of renal origin.

Genistein alleviates the mitochondria-targeted DNA damage induced by β-amyloid peptides 25–35 in C6 glioma cells

Reactive oxygen species (ROS) are mainly produced by mitochondria which can cause oxidative stress. It has been considered that mitochondrial damage induced by oxidative stress is related to Alzheimer's disease (AD). Besides, mitochondrial DNA (mtDNA) is more vulnerable to oxidative damage than other biomacromolecules, causing serious dysfunction to mitochondria. β-amyloid peptides (Aβ) is a main factor responsible for the occurrence and development of AD. Astrocytes is an important target cell for Aβ' toxicity and can be activated to neglect their normal fountain in the central nervous system. Genistein (Gen), a main active ingredient of soybean isoflavone, has been shown to have neuroprotective effects by antagonizing oxidative damage induced by Aβ. Thus, in the present study, we evaluated Aβ25-35 induced mitochondrial DNA (mtDNA) damage and the protective effect of Gen in C6 glioma cells (C6 cells). The study design was consisted of four groups: control group (vehicle), Aβ group treated with Aβ25-35, Gen + Aβ group treated with Gen + Aβ25-35 and Gen group treated with Gen only. C6 cells were pre-incubated with or without Gen (50 μM) for 2 h followed by the incubation with Aβ25-35 (25 μM) for another 24 h. Then the cells were harvested and processed to perform the analysis according to protocols. The mitochondrial ROS in C6 cells were measured by fluorescence spectrometer. Enzyme-linked immunosorbent assay (ELISA) was used to detect the mitochondrial reduced glutathione (GSH) and oxidized glutathione (GSSG) in C6 cells, then the ratio of GSH and GSSG was calculated. The levels of 8-hydroxydeoxyguanosine (8-OHdG) in C6 cells was also detected by ELISA. In addition, mtDNA deletion was detected by polymerase chain reaction (PCR). The mRNA and protein expression of 8-oxoguanine DNA glycosylase (OGG1) in both C6 cells and its mitochondria, and manganese superoxide dismutase (MnSOD) in mitochondria were detected by using reverse transcription-PCR and Western blot. The results showed that the increased mitochondrial ROS accumulation in C6 cells induced by Aβ was profoundly reversed by pre-treaded with Gen (p < 0.05). The ratio of GSH and GSSG in mitochondria was significantly increased in both Gen + Aβ group and Gen group compared with Aβ group (p < 0.05). The levels of 8-OHdG in C6 cells and mtDNA deletion were decreased after pre-treated with Gen (p < 0.05). Gen could also up-regulate the mRNA and protein expression of OGG1 in both C6 cells and its mitochondria and mitochondrial MnSOD compared with the Aβ group (p < 0.05). These results confirmed that Gen could alleviate the mitochondria-targeted oxidative damage induced by β-amyloid 25-35 in C6 cells which might be useful for the treatment of neurodegenerative diseases.

A Unique Patient Population? Health-Related Quality of Life in Adolescent Athletes Versus General, Healthy Adolescent Individuals

Normative scores for patient-rated outcome (PRO) instruments are important for providing patient-centered, whole-person care and making informed clinical decisions. Although normative values for the Pediatric Quality of Life Generic Core Scale (PedsQL) have been established in the general, healthy adolescent population, whether adolescent athletes demonstrate similar values is unclear. To compare PedsQL scores between adolescent athletes and general, healthy adolescent individuals. Cross-sectional study. Secondary schools. A convenience sample of 2659 interscholastic athletes (males = 2059, females = 600, age = 15.7 ± 1.1 years) represented the athlete group (ATH), and a previously published normative dataset represented the general, healthy adolescent group (GEN). All participants completed the PedsQL during 1 testing session. The PedsQL consists of 2 summary scores (total, psychosocial) and 4 subscale scores (physical, emotional, social, school), with higher scores indicating better health-related quality of life (HRQOL). Groups were stratified by age (14, 15, or 16 years old). Independent-samples t tests were conducted to compare between-groups and sex differences. The ATH group scored higher than the GEN group across all ages for total and psychosocial summary scores and for emotional and social functioning subscale scores (P ≤ .005). For physical functioning, scores of the 15-year-old ATH were higher than for their GEN counterparts (P = .001). Both 14- and 15-year-old ATH scored higher than their GEN counterparts for the school functioning subscale (P ≤ .013), but differences between 16-year olds were not significant (P = .228). Male adolescent athletes reported higher scores than female adolescent athletes across all scores (P ≤ .001) except for social functioning (P = .229). Adolescent athletes reported better HRQOL than GEN, particularly in emotional functioning. These findings further support the notion that ATH constitutes a unique population that requires its own set of normative values for self-reported, patient-rated outcome instruments.