LP Group Research Articles

Leucine improves dietary protein use efficiency by regulating protein synthesis by activating amino acid transporters and the mTORC1 pathways in Chinese mitten crab (Eriocheir sinensis)

Leucine plays a critical role in protein metabolism and energy homeostasis. This study determines whether leucine supplementation increases body protein synthesis in juvenile E. sinensis while consuming less protein than their requirements. It also investigates the effects of leucine on molecular mechanisms regulating protein synthesis. The 8-week growth trial included three dietary protein levels (22%, 30% or 38%) crossing three leucine levels (1.1, 2.5 or 5.0%). In the trial, 1440 crabs (0.40 ± 0.05 g) were allocated to a 3 × 3 factorial experiment with four replicates of 40 crabs each. The WG and SGR of the NP group were significantly higher than those of the LLP group when the diet contained 1.1% leucine (P < 0.05). The WG, SGR and whole-body protein content of the LP group were significantly higher than those of the LLP group with 2.5% leucine added to the diet (P < 0.05) but not significantly different from those of the NP group (P > 0.05). However, when 5% leucine was added to the diet, the whole-body protein content of the LP group was significantly higher than that of the LLP group (P < 0.05). Dietary leucine supplementation significantly improved growth performance, increased crude protein and decreased crude lipids in the crabs. When the diet contained 30% crude protein, the highest WG, SGR, PER and PRR appeared in the LP-2.5 group (P > 0.05). The PER and PRR of the NP-2.5 group were significantly higher than those of the NP-1.1 group (P < 0.05) and were not significantly different from those of the NP-5.0 group (P > 0.05). In addition, the whole-body protein content of the NP-2.5 group was significantly higher than that of the NP-1.1 and NP-5.0 groups (P < 0.05). Growth hormone and ecdysterone significantly increased with dietary protein levels. The highest growth hormone and ecdysterone in the hemolymph occurred in the 2.5% leucine groups. Moreover, leucine supplementation significantly increased lipase and amylase activity in the hepatopancreas (P < 0.05). The 2.5% leucine supplementation significantly increased CAT activity and decreased MDA in the hepatopancreas. Dietary leucine significantly increased hemocyanin in the hemolymph, and the expression of amino acid transporter genes was significantly increased with dietary leucine supplementation. The crabs fed 2.5% leucine supplementation had the highest gene expression of the mTOR pathway, indicating that dietary leucine significantly promotes amino acid transport and protein synthesis in the hepatopancreas and muscles. This study suggests that a low-protein diet can inhibit animal protein synthesis and decrease energy accumulation and growth. The 2.5% leucine supplementation in the 30% protein diet effectively could promote protein synthesis and utilization and improve crabs growth and protein utlization.

The association of lipoprotein(a) with patient characteristics and mortality in a primary prevention cohort: data from our clinic database

Abstract Background Lipoprotein(a) [Lp(a)] has emerged as a causal risk factor for development of cardiovascular (CVD) and valvular heart disease. However, not much is known about the gender differences and Lp(a). The aim of our study was to investigate gender differences in clinical and laboratory characteristics of primary prevention patients with elevated Lp(a) and to study the associations between Lp(a) and all-cause mortality by gender. Method We analyzed data obtained from the Preventive Cardiology Information System (PreCis), a database of clinical and laboratory information on 8,136 consecutive primary prevention patients seen at our clinic preventive cardiology clinic from 1999-2018. Primary prevention was defined as having no history of coronary artery disease (CAD), coronary and peripheral arterial revascularization, nor atherosclerosis. Data regarding mortality were gathered from a combination of sources including the Social Security Death Index (SSDI), the Ohio State Department of Health Vital Statistics, and electronic medical record. All-cause mortality was assessed using time to event analyses, and adjusted Cox proportional hazards models. All statistical analyses were conducted using SAS version 9.4. Result In the overall cohort (n=8,136), 57% were female at a median age of 54 years and 43% were male at a median age of 52 years. Median Lp(a) was 24 (IQR 8-63) mg/dL in females and 18.6 (IQR 7-51) mg/dL in males. The proportion of females increased with increasing Lp(a) values from 54% with Lp(a) &amp;lt;30 mg/dL to 69% with Lp(a) ≥90mg/dL. Female patients with Lp(a) ≥50 mg/dL were significantly more likely to have dyslipidemia (40.5% vs 34.1%; p&amp;gt;0.001) and hypertension (27.3% vs 23.3%; p&amp;gt;0.001) compared to &amp;lt;50 mg/dL. There was a trend toward increased all-cause mortality in elevated Lp(a) group among female patients (&amp;lt;50 mg/dL vs ≥50 mg/dL; (HR (95%CI): 1.22 (0.98-1.52); p=0.083). Conclusion In this primary prevention population, a higher proportion of females had elevated Lp(a) than males. Females with elevated Lp(a) presented with more comorbidities and a trend towards increased all-cause mortality. These findings suggest a gender difference in the distribution of Lp(a) and all-cause mortality in the primary prevention setting, which warrants further investigation.

Syndesmosis Injuries in Lateral Malleolar Fractures Accompanied by a Posterior Malleolar Fracture: A Nonfixed Posterior Fracture Fragment May Not Affect Postoperative Tibiofibular Joint Malreduction Rates.

The fact that lateral malleolar fracture is accompanied by posterior malleolar fracture may adversely affect syndesmosis malreduction rates. We aimed to compare syndesmosis malreduction rates determined on postoperative radiographs between isolated lateral malleolar fractures and lateral malleolar fractures accompanied by posterior malleolar fractures. We retrospectively examined 128 operative patients: 73 with isolated lateral malleolar fractures (group L) and 55 with lateral + posterior malleolar fractures (group LP). In group LP, no patients received posterior fragment fixation. In both groups, indirect syndesmosis fixation was performed with a single screw after open reduction and internal fixation of the lateral malleolus. Patient age, sex, fracture side, fracture type (Lauge-Hansen and Danis-Weber classifications), Kellgren-Lawrence osteoarthritis classification, syndesmotic incongruency on postoperative radiographs, syndesmotic malreduction of postoperative fibula fracture, fracture union time, complication rates, accompanying injuries, and preoperative and postoperative radiographic syndesmotic measurements (tibiofibular overlap, tibiofibular clear space, medial clear space) were recorded, and the groups were compared. Mean ± SD age was 44.32 ± 15.66 years in group L and 48.93 ± 14.03 years in group LP (P = .087). There were no significant differences in preoperative and postoperative tibiofibular distance, tibiofibular overlap, and medial clear space values between groups (P > .05). The prevalence of grade 2 fractures according to the Kellgren-Lawrence classification was significantly higher in group LP (P = .047). Postoperative syndesmosis malreduction was detected in 12 patients in group L and in nine in group LP (P = .991). In lateral malleolar fractures accompanied by small-fragment posterolateral or avulsion-type posterior malleolar fractures, closed syndesmotic screw fixation does not cause syndesmosis malreduction.

Safety and effectiveness of the first contact force ablation catheter with a flexible tip

Catheter ablation is an established therapy for paroxysmal atrial fibrillation (PAF). The TactiFlex Ablation Catheter, Sensor Enabled (TactiFlex SE) is a next-generation radiofrequency ablation catheter incorporating fiber optics-based contact force-sensing technology with a flexible, laser-cut tip. The study sought to evaluate the safety and effectiveness of the TactiFlex SE ablation catheter for treatment of drug-refractory PAF. The TactiFlex AF investigational device exemption was a prospective, nonrandomized, multicenter clinical study. Enrollment began on June 26, 2020 and completed June 18, 2021. Subjects with PAF underwent de novo pulmonary vein isolation and, if indicated, ablation for typical atrial flutter. Subjects were followed for 12 months. Of the 355 subjects enrolled at 37 sites worldwide, 334 underwent ablation with the TactiFlex SE catheter. The Kaplan-Meier estimate of 12-month freedom from AF/atrial flutter (AFL)/atrial tachycardia recurrence was 72.9% (95% confidence interval [CI] 95% CI 67.2%-77.8%) and clinical success was 83.6% (95% CI 95% CI 78.1%-87.2%). As-treated analyses compared subjects treated at high power (left atrium time-averaged power setting 40-50 W; n = 222) vs low power (<40 W; n = 97). The Kaplan-Meier estimate of 12-month freedom from AF/AFL/atrial tachycardia recurrence was 76.4% (95% CI 69.3%-82.0%) and clinical success was 83.9% (95% CI 77.5%-88.6%) in the high-power group compared with 66.8% (95% CI 56.1%-75.5%) and 80.7% (95% CI 70.8%- 87.5%), respectively, in the low-power group. The primary safety event rate in all treated subjects was 4.3%; 4.1% in the HP group and 5.2% in the LP group (P = .7671). TactiFlex SE is safe and effective for treatment of drug-refractory PAF and concomitant AFL and enables more efficient procedures than previous generation catheters.

Lenvatinib Plus PD-1 Inhibitors versus Regorafenib in Patients with Advanced Hepatocellular Carcinoma After the Failure of Sorafenib: A Retrospective Study.

To evaluate the clinical outcomes of lenvatinib plus PD-1 inhibitors (LP) and regorafenib (R) in patients with advanced hepatocellular carcinoma (HCC) after sorafenib failure. From June 2018 to September 2021, 68 patients from a single center who received lenvatinib combined with PD-1 inhibitors or regorafenib after sorafenib treatment failure were analyzed. The tumor response and survival outcomes were compared between the LP group and R group. Prognostic factors for OS and PFS were determined using Cox proportional hazard regression models. The ORR increased in the LP group (19.5% vs 7.4%, p =0.294), and the DCR was better in the R group (73.2% vs 44.4%, p =0.017). Additionally, median PFS and OS were not significantly different between the LP group and R two groups in survival analysis (PFS: 5.3 months vs 3.0 months, p =0.633; OS: 11.8 months vs 8.0 months, p =0.699). The common adverse events (≥grade 3) were hand-foot skin reactions (13.1%). In multivariate analyses, AFP≥400 ng/mL and ECOG PS 2 were independent risk factors for poor prognosis. The LP group appeared to have a trend of greater tumor response and a higher disease control rate than the R group among patients with sorafenib-resistant HCC, although PFS and OS did not differ significantly between the two groups.

Evaluation of regulatory capacity of three lactic acid bacteria on the growth performance, non-specific immunity, and intestinal microbiota of the sea cucumber Apostichopus japonicus

Lactic acid bacteria (LAB) have been extensively used as probiotics in aquaculture. However, probiotic effects of different inter-generic strains of LAB on sea cucumber Apostichopus japonicus are still poorly understood. Here, sea cucumber were fed with five diets for 63 days, including a basal diet (the control, C group), a florfenicol diet (15 mg/kg; the positive control, FL group) and three LAB diets, i.e., the basal diets supplemented with Lactobacillus plantarum W2 (LP group), Enterococcus faecium LYB (EF group) and Pediococcus acidilactici Nj (PA group) at the dose of 1 × 1010 CFU/kg diet, respectively. A stimulation test with inactivated Vibrio splendidus was then performed and characterized immune responses of sea cucumber over 168 h. The results showed that all three LAB significantly enhanced the growth performance of sea cucumber, with the LP diet showed the best growth-promoting effect. The LP and PA diets significantly increased coelomocyte phagocytic, respiratory burst, superoxide dismutase, alkaline phosphatase, acid phosphatase, catalase, and lysozyme activities. The LP and EF diets significantly up-regulated the intestinal immune genes (Aj-p105, Aj-p50, Aj-rel, and Aj-lys) expression levels, while PA diet did not significantly up-regulate the Aj-p50 gene expression level. Meanwhile, all three LAB significantly enhanced intestinal immune response. Florfenicol diet significantly decreased phagocytic and alkaline phosphatase activities, down-regulated the Aj-lys gene expression, and suppressed intestinal immune response. L. plantarum W2 significantly increased the diversity of the intestinal microbiota in sea cucumber, and the P. acidilactici Nj significantly improved both the diversity and richness. A higher relative abundance of Actinobacteriota, norank_f_Rhodobacteraceae, and Sedimentitalea was observed in the LP, EF, and PA groups, respectively, while a lower relative abundance of Firmicutes was showed in the FL group. All three LAB improved the stability of the intestinal microbial networks and up-regulated the functional pathways of intestinal microbiota associated with amino acid metabolism. However, florfenicol reduced microbial network stability and significantly inhibited the intestinal microbiota functions. In conclusion, L. plantarum W2, E. faecium LYB, and P. acidilactici Nj can be effectively used as probiotics in sea cucumber aquaculture. Among them, L. plantarum W2 exhibited the best effect on sea cucumber when the growth performance, non-specific immunity, and intestinal microbial structure and functions were considered collectively.

Impact of Lipoprotein (a) on Long-Term Outcomes in Patients With Acute Myocardial Infarction.

Lipoprotein (a) (Lp(a)) is a complex circulating lipoprotein, and there is increasing evidence it is a risk factor for atherosclerotic cardiovascular disease (ASCVD). This study aimed to investigate the influence of Lp(a) serum levels on long-term outcomes after acute myocardial infarction (AMI). Between January 2015 and January 2018, we enrolled 262 patients with AMI who underwent coronary angiography within 24 h of the onset of chest pain and had available Lp(a) data enabling subdivision into 2 groups: high Lp(a) (≥32 mg/dL: n=76) and low Lp(a) (<32 mg/dL: n=186). The primary endpoint was major adverse cardiac events (MACE), which was defined as a composite of cardiac death, nonfatal MI, and readmission for heart failure. Multivariate Cox regression analysis was performed to identify the predictors of MACE. The incidence of MACE was significantly higher in the high Lp(a) group than in the low Lp(a) group (32.8% vs. 19.6%, P=0.004). Multivariate analysis showed that Lp(a) ≥32 mg/dL was an independent predictor of MACE (hazard ratio 2.84, 95% confidence interval 1.25-6.60, P=0.013). High Lp(a) levels were associated with worse long-term outcomes after AMI, so Lp(a) may be useful for risk assessment.

Laparoscopic Pectopexy versus Vaginal Sacrospinous Ligament Fixation in the Treatment of Apical Prolapse.

To compare the follow-up results of a sacrospinous ligament fixation (SSLF) technique for laparoscopic bilateral fixation of the vagina to the iliopectineal ligament via a PVDF-mesh (laparoscopic pectopexy technique, LP) in terms of cure rate and postoperative complications rate. This prospective study included 160 patients diagnosed with pelvic organ prolapse stage II-IV according to the POP-Q system. Eighty-two patients (51.25%) underwent vaginal sacrospinous ligament fixation and seventy-eight patients (48.75%) underwent the laparoscopic pectopexy procedure. The cure rate was high in both groups, 95.12% of the patients (78 out of 82) in the SSLF group and 93.59% of the patients (73 out of 78) in the LP group were cured post surgery, leading to an overall cure rate of 151 out of 160 patients. Pelvic pain was present in 5.00% of all patients, but was notably more frequent in the SSLF group (7, 8.54%) than in the LP group (1, 1.28%). Dyspareunia occurred in 4.37% of all patients, slightly more frequently in the SSLF group (6, 7.32%) than the LP group (1, 1.28%), but without significant difference. The laparoscopic pectopexy procedure has comparably positive follow-up results with the conventional sacrospinous ligament fixation procedure. Both SSLF and LP are effective in the treatment of pelvic organ prolapse, with favorable anatomical and subjective results, a high cure rate and low rates of serious postoperative complications.

Interactive Effect of Dietary Heat-Killed Lactobacillus Plantarum L-137 and Berberine Supplementation on Intestinal Mucosa and Microbiota of Juvenile Black Sea Bream (Acanthopagrus Schlegelii).

To compare the synergistic impact of dietary heat-killed Lactobacillus plantarum and berberine supplementation on intestinal health of juvenile black sea bream, the test fish (5.67 ± 0.05g) were fed three diets: a basal control diet designated as Con; basal diet supplemented with 400mg/kg L. plantarum, labelled LP; and basal diet supplemented with 400mg/kg L. plantarum + 50mg/k berberine, labelled LPBB. After 56days of feeding, the control fish had significantly lower intestinal villus height (VH), villus surface area (VSA), and muscularis mucosae (MS) thickness than the rest of the groups (P < 0.05). The LPBB fish had significantly higher VH than the control fish, and wider MS and VSA than the rest of the groups (P < 0.05). Occludin was significantly upregulated in the LPBB fish, and heat shock protein 90 was upregulated in the control fish (P < 0.05). The abundance of Proteobacteria family was significantly higher in the intestinal microbiome of the control and LP fish, the LPBB fish had higher abundance of Cyanobacteria and Spirochaetes, and the LP group had higher Bacteroidetes abundance (P < 0.05). Potentially beneficial Delftia and Brevinema were the significantly abundant genera in the LP and LPBB fish, respectively; potentially pathogenic Elizabethkingia was abundant in the LP fish; and the control fish had higher abundance of potentially pathogenic Burkholderia-Caballeronia-Paraburkholderia (P < 0.05). According to these results, there is possible synergy between L. plantarum and berberine as dietary supplements in fostering healthy intestine for black sea bream than L. plantarum alone.

Lipoprotein(a) is a new prognostic factor in patients with psoriasis and coronary artery disease: a retrospective cohort study

BackgroundThe prognostic value of lipoprotein (Lp) (a) in patients who have suffered from coronary artery disease (CAD) has not been fully studied, and the results are inconsistent. This study was conducted to evaluate whether increased Lp(a) concentrations cause differences in clinical adverse outcomes in patients with psoriasis who have already suffered from CAD.MethodsThis retrospective cohort study included consecutive patients with psoriasis and CAD between January 2017 and May 2022 in our hospital. The clinical records were collected, and comparisons were made between patients in the low Lp(a) and high Lp(a) groups. Cox proportional hazard analysis and log-rank tests were used to evaluate the association between variables.ResultsAmong 295 patients, 148 patients were in the low Lp(a) group, and 147 were in the high Lp(a) group. These two groups did not differ significantly in age, gender or body mass index. Compared with the low Lp(a) group, the levels of platelet counts (P = 0.038) and high sensitivity C reactive protein (P = 0.012) were higher in the high Lp(a) group. Patients in the high Lp(a) group had higher total cholesterol levels (P = 0.029) and lower triglyceride levels (P = 0.037). Among the whole cohort, clinical adverse events were not correlated with Lp(a) concentrations after a median follow-up of 3 years. However, in the subgroup analysis, there were significant differences in all-cause death (log rank P = 0.036) and rehospitalization (log rank P = 0.037) between the two groups in patients with diabetes; a difference in rehospitalization (log rank P = 0.042) was also found between the two groups in men.ConclusionsIn patients with psoriasis and CAD, high levels of Lp(a) were related to a poor prognosis, especially in patients with diabetes and in men. These results will provide valuable information for the risk stratification of patients with psoriasis and CAD.

Lost in Translation: A Preliminary Examination of Phonological Processing, Language, and Reading in Childhood Epilepsy

ABSTRACTChildren with epilepsy are at increased risk for language and reading difficulties. Phonological processing and language underlie reading success, yet their association with reading achievement in children with epilepsy is unknown. We assessed phonological processing, oral language, and reading in children (ages 6 to 12) with epilepsy (EP; n = 6), language problems (LP; n = 14), and typical development (TD; n = 15). The EP and LP group had lower scores on all measures compared with the TD group, with the EP group scoring the lowest on reading comprehension. Phonological processing followed by epilepsy diagnosis predicted reading decoding. Language followed by epilepsy diagnosis predicted reading comprehension. Thus, reading problems in children with epilepsy are not fully explained by their phonological processing or language deficits. Further research that considers other cognitive processes important for reading (e.g., executive function) in this population may help inform our understanding of their reading success.

Rumen-protected lysine supplementation improved amino acid balance, nitrogen utilization and altered hindgut microbiota of dairy cows

This study was conducted to evaluate the effects of dietary crude protein (CP) and rumen-protected lysine (RPL) supplementation on lactation performance, amino acid (AA) balance, nitrogen (N) utilization and hindgut microbiota in dairy cows. Treatments were in a 2 × 2 factorial arrangement, and the main effects were CP concentration (16% vs. 18%) and RPL supplementation (with or without RPL at 40 g/cow per day). Forty cows were randomly allocated to 4 groups: low-CP diet (LP), low-CP diet plus RPL (LPL), high-CP diet (HP), high-CP diet plus RPL (HPL). The experiment was conducted for 8 weeks. Results showed that RPL increased the dry matter intake (P < 0.01), milk protein yield (P = 0.04) and energy corrected milk (P = 0.04), and tended to increase milk fat yield (P = 0.06) and fat corrected milk (P = 0.05). Cows in the HP group tended to have higher milk urea N (P = 0.07). Plasma concentrations of Arg, Ile, Lys, Met, Pro, total essential AA and total nonessential AA were increased by RPL (P < 0.05). The total essential AA, total nonessential AA and most AA (except Ile, Phe, Gly and Pro) were increased in the HP group (P < 0.05). N excretion was increased in the HP group through an increase in urea N excretion (P < 0.01) and an upward trend in plasma urea N (P = 0.07). In addition, RPL tended to increase milk protein N secretion (P = 0.08), milk N (P = 0.07) and microbial protein synthesis (P = 0.06), and decreased plasma urea N (P < 0.001). In the hindgut, the bacterial community were different between the LP and LPL groups (P < 0.01). The probiotic abundances of Christensenellaceae_R-7_group and Acinetobacter were increased by RPL (P = 0.03 and 0.03, respectively). The pathogenic abundances of Clostridium_sensu_stricto_1 (P < 0.001) and Turicibacter (P < 0.01) were decreased by RPL. In conclusion, supplementing RPL with low dietary CP could balance AA supply and increase milk protein yield, resulting in an improvement in N utilization efficiency, and altered the composition of the hindgut microbiota to favor the lactation performance of dairy cows.

Diet enriched in saturated fatty acids induces liver oxidative stress and elicits inflammatory pathways prior to metabolic disruption in perinatal protein undernutrition

The impact of diets high in saturated fatty acids in individuals who have undergone maternal protein restriction is not clear. Here, we tested the hypothesis that a saturated fatty acid–enriched hyperlipidic diet (HL) affects liver expression of genes of the redox balance and inflammatory pathway in postweaning rat offspring subjected to maternal protein restriction. Pregnant Wistar rats received either a control (C; 19% protein) or low protein (LP; 8% protein) diet during gestation and lactation. At weaning, pups received either C or HL diets up to 90 days of life. The LP+HL group showed an upregulation of transcription of peroxisome proliferator-activated receptor γ (+48%) and peroxisome proliferator-activated receptor γ coactivator α (+96%) compared with the LP+C group (P < .05), respectively. Similarly, gene expression of the markers of inflammation, nuclear factor-kappa B1 (+194%) and tumor necrosis factor-α (+192%), was enhanced (P < .05). Although other antioxidant enzymes were not modified in gene expression, catalase (CAT) was 66% higher in LP+HL compared with LP+C. In contrast, CAT protein content in the liver was 50% lower in LP groups compared with C, and superoxide dismutase 2 (SOD2) was twice as high in LP groups compared with C. Postweaning HL after maternal protein restriction induces hepatic metabolic adaptation characterized by enhanced oxidative stress, unbalanced expression in the antioxidant enzymes SOD1, SOD2 and CAT, and activation of inflammatory pathways but does not impact circulating markers of lipid metabolism and liver function.

Impact of C3 laminectomy on cervical sagittal alignment in cervical laminoplasty: a prospective, randomized controlled trial comparing clinical and radiological outcomes between C3 laminectomy with C4–C6 laminoplasty and C3–C6 laminoplasty

Background ContextC3 laminectomy in cervical laminoplasty is a modified laminoplasty technique that can preserve the semispinalis cervicis muscle attached to the C2 spinous process. Several previous studies have shown that this technique can lead to better outcomes of postoperative axial neck pain and C2–C3 range of motion (ROM) than conventional cervical laminoplasty. However, there is still a lack of understanding of total and proportional postoperative cervical sagittal alignment outcomes. PurposeTo assess the effects of C3 laminectomy in cervical laminoplasty on postoperative cervical alignment and clinical outcomes. DesignA single-center, patient-blinded, randomized controlled trial. Patient SampleWe included consecutive 126 patients diagnosed with cervical spondylotic myelopathy (CSM) or ossification of posterior longitudinal ligament (OPLL) who were scheduled for cervical laminoplasty from March 2017 to January 2020. Outcome MeasuresThe primary outcome measures were C2–C7 Cobb angle (CA) and neck disability index (NDI). Secondary outcomes measures included other clinical outcomes and radiographic parameters including segmental Cobb angle and presence of C2–C3 interlaminar fusion. MethodsPatients were randomly allocated to either the C3 laminectomy with C4–C6 laminoplasty group (LN group) or the C3–C6 laminoplasty group (LP group) at a 1:1 ratio. Laminoplasty was performed using a unilateral open-door technique and stabilized with titanium mini plates. A linear mixed model analysis was employed to examine the longitudinal data from postoperative 1-year through 3-year. Additional analysis between three types of cervical sagittal alignment morphology was done. ResultsAmong 122 patients who were randomly allocated to one of two groups (LN group, n=61; LP group, n=61), modified intent-to-treat analysis was done for 109 patients (LN group, n=51, LP group, n=58) who had available at least a year of postoperative data. Postoperative C2–C7 CA was not significantly different between the two groups. However, NDI was significantly different between the two groups (12.8±1.0 in the LN group vs 8.6±1.0 in LP group, p=.005), which exceeded the minimum clinically important difference (MCID). The postoperative C2–C3 CA was significantly greater in the LN group (7.1±0.5° in LN group vs 3.2±0.5° in LP group, p<.001) while C4–C7 CA was significantly smaller in the LN group (3.9±0.8° in LN group vs 7.7±0.7° in LP group, p<.001) with greater cSVA in the LN group (31.6±1.4 mm in LN group vs 25.5±1.3 mm in LP group at postoperative 3-year, p=.002). Postoperative Euro-Quality of Life-5 Dimension (EQ-5D), numerical rating scores for neck pain (NRS-N) were significantly better in the LP group than in the LN group (all p<.05) and only EQ-5D surpassed the MCID. The C2-C3 fusion rate was significantly different between the LN group (9.8%) and the LP group (44.8%) (p<.001). The LN group showed a higher prevalence of a specific cervical alignment morphology characterized by a sigmoid shape with proximal lordosis and distal kyphosis (S curve). This S curve demonstrated significantly unfavorable outcomes across multiple outcome variables. ConclusionThe impact of C3 laminectomy in cervical laminoplasty on postoperative kyphosis among patients with CSM or OPLL did not significantly differ from that of C3–C6 laminoplasty. However, C3 laminectomy in cervical laminoplasty might result in an unfavorable clinical outcome with an unbalanced cervical sagittal alignment characterized by a sigmoid shape with proximal lordosis and distal kyphosis.

Chromatic pupillometry isolation and evaluation of intrinsically photosensitive retinal ganglion cell-driven pupillary light response in patients with retinitis pigmentosa.

The pupil light response (PLR) is driven by rods, cones, and intrinsically photosensitive retinal ganglion cells (ipRGCs). We aimed to isolate ipRGC-driven pupil responses using chromatic pupillometry and to determine the effect of advanced retinitis pigmentosa (RP) on ipRGC function. A total of 100 eyes from 67 patients with advanced RP and 18 healthy controls (HCs) were included. Patients were divided into groups according to severity of visual impairment: no light perception (NLP, 9 eyes), light perception (LP, 19 eyes), faint form perception (FFP, 34 eyes), or form perception (FP, 38 eyes). Pupil responses to rod-weighted (487 nm, -1 log cd/m2, 1 s), cone-weighted (630 nm, 2 log cd/m2, 1 s), and ipRGC-weighted (487 nm, 2 log cd/m2, 1 s) stimuli were recorded. ipRGC function was evaluated by the postillumination pupil response (PIPR) and three metrics of pupil kinetics: maximal contraction velocity (MCV), contraction duration, and maximum dilation velocity (MDV). We found a slow, sustained PLR response to the ipRGC-weighted stimulus in most patients with NLP (8/9), but these patients had no detectable rod- or cone-driven PLR. The ipRGC-driven PLR had an MCV of 0.269 ± 0.150%/s and contraction duration of 2.562 ± 0.902 s, both of which were significantly lower than those of the rod and cone responses. The PIPRs of the RP groups did not decrease compared with those of the HCs group and were even enhanced in the LP group. At advanced stages, ipRGC responses gradually became the main component of the PLR. Chromatic pupillometry successfully isolated an ipRGC-driven PLR in patients with advanced RP. This PLR remained stable and gradually became the main driver of pupil contraction in more advanced cases of RP. Here, we present baseline data on ipRGC function; we expect these findings to contribute to evaluating and screening candidates for novel therapies.

Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress.

This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). Among the 507 participants (mean age 22.2 ± 1.5years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. Oral parafunction appears to be a dysfunctional coping response to psychological distress.

A Multicentric Comparative Study Between Laparoscopic Pyeloplasty and Open Pyeloplasty in Children with Ureteropelvic Junction Obstruction

.Laparoscopic Pyeloplasty with its pediatric application was first described by (Peters et al.,1995), from that time till now the surgical hand skill has evolved lead to speed up the operation with Laparoscopy continue to show a preference for the transperitoneal approach, but the feasibility of retroperitoneoscopic pyeloplasty has also been demonstrated effective results. Aim of the study: To compare the Laparoscopic and Open Pyeloplasty in the management of Pediatric Patients with Ureteropelvic Junction Obstruction. Patients &amp; methods: Multicentric comparative prospective study concluded from 1st of October 2018 till 1st of October 2020, fifty patients enrolled in the study. 20 patients (12 male,8 female) undergo LP pyeloplasty with mean age is 11.5 years old in Al_Diwaniya teaching hospital,30 patients (21 male,9 female) undergo OP pyeloplasty with mean age is 4 years old in Al_Diwaniyah teaching hospital and Al_Sader Medical city. Results: The operative time in the LP group was found longer than the OP group (with a mean difference 30min.), with no organ injury, no conversion to OP pyeloplasty, with comparable hospital stay between two groups, less pain, and better cosmetic’s acceptance for LP group. Conclusion: Short-term outcome of LP pyeloplasty is comparable to OP pyeloplasty regarding hospital stay, no organ injury, no conversion, less analgesic requirement, and better cosmetics acceptance, which can consider promising gold standard surgical intervention for the repair of UPJO nowadays particularly in pediatric patients

The aqueous extract of Leptadenia Pyrotechnica Decne enhances the innate immune response and inhibits the acquired immune response, while the aqueous extract of Capparis Cartilaginea Decne does the exact opposite in Healthy Rats

Leptadenia pyrotechnica (Forssk.) Decne. (LP) and Capparis cartilaginea Decne. (CC) are plants used in local folk medicine, although there are no published studies on their physiological, hematological, and immune system effects. This study is the first to determine and compare the effects of aqueous LP and CC extracts on body weight parameters, consumptions of feed and water, and the differential complete blood counts in blood samples of healthy Wister albino rats. Six groups of rats (3 rats/group) were orally gavage separately with the aqueous extracts of LP (groups LP1, LP2, and LP3, respectively) and CC (groups CC1, CC2, and CC3, respectively) at concentrations of 30, 100, and 200 mg/kg body weight, while three control rats were gavage with water, daily for two weeks. Body weights were measured daily. The mean total body weights were not significantly different between all groups, between the experimental groups and the control group, and between the equal concentrations of LP and CC groups. The mean total and daily body weight gains and percent relative total body weight gain for the LP3 group were significantly lower compared with the control group. The mean feed and water intakes were highly significantly lower for the LP2, LP3, CC2, and CC3 groups compared with the control group, and for the LP3 group it was significantly lower compared with the CC3 group. The FER for the LP3 group was significantly lower compared with the control group. The mean lymphocyte percent for CC1 was significantly higher and the mean lymphocyte count for LP1 was significantly lower compared with the control. The mean neutrophil percent for LP1 was significantly higher than for CC1 and the mean lymphocyte percents for LP1 and LP2 were significantly lower than for CC1 and CC2. In conclusion, the LP extract enhances the innate immune response and inhibits the acquired immune response, while the CC extract does the exact opposite. Thus, the extract may be used for modulating the immune response.

Allografts are not necessary for displaced proximal humeral fractures in patients less than 65 years old, a retrospective cohort study

IntroductionDisplaced proximal humeral fractures (PHF) are frequently treated with locking plates to achieve osteosynthesis. Bone grafts are used as augmentation techniques to improve stability in osteoporotic patients. However, there has been little research into whether bone grafts are necessary for patients younger than 65 years old. This study compared radiographic and clinical outcomes between PHFs augmented with bone grafts or not in a younger population. MethodsBetween January 2016 and June 2020, 91 patients treated with a locking plate alone (LP), and 101 patients treated with locking plates augmented with bone grafts (BG) were analyzed. Potential confounding factors for outcomes were adjusted by propensity score-matching analyses. For the retrospective cohort study, 62 patients from each group were evaluated for radiographic outcomes and clinical outcomes and compared. ResultsSixth-two patients in each group, both with a mean age of 52 years old, were with a mean follow-up time of 25 months in the LP group and 26 months in the BG group. There was no difference in demographic or surgical characteristics between the two groups after propensity score-matching. With regard to radiographic outcomes, the changes in neck-shaft angle (−5.1 ± 4.9 vs. −3.1 ± 5.3, p = 0.015) and humeral head height (−1.5 ± 2.5 vs. −0.4 ± 2.7, p = 0.002) were more obvious in the BG group. However, regarding functional outcomes, there were no significant differences between the two groups in DASH score, Constant–Murley score, or VAS score. Moreover, the complication rate was not significantly different between two groups. DiscussionAllografts only provide minor improvements of stability in radiography for patients less than 65 years old after locking plate fixation of PHFs, but don't improve shoulder function, relieve pain or reduce complications. We concluded that allografts are unnecessary for younger patients with displaced PHFs.

Effects of different n-6/n-3 polyunsaturated fatty acids ratios on lipid metabolism in patients with hyperlipidemia: a randomized controlled clinical trial.

Intake of n-3 polyunsaturated fatty acids (PUFA) is helpful for cardiometabolic health. It improves lipid metabolism, and increasing n-3 PUFA is often considered beneficial. However, the role of n-6/n-3 in the regulation of lipid metabolism has been much debated. Therefore, this study was performed on the effect of different proportions of n-6/n-3 diet on lipid metabolism, and quality of life in patients with hyperlipidemia, aiming to explore appropriate proportions of n-6/n-3 to provide the theoretical basis for the development and application of nutritional blended oil in the future. These 75 participants were randomized and assigned into three groups, which received dietary oil with high n-6/n-3 PUFA ratios (HP group: n-6/n-3 = 7.5/1), dietary oil with middle n-6/n-3 PUFA ratios (MP group: n-6/n-3 = 2.5/1) or low n-6/n-3 PUFA ratios (LP group: n-6/n-3 = 1/2.5). All patients received dietary guidance and health education were monitored for hyperlipidemia. Anthropometric, lipid and blood glucose parameters and quality of life were assessed at baseline and 60 days after intervention. After 60 days, high-density lipoprotein cholesterol (HDL-c) level was increased (p = 0.029) and Total cholesterol (TC) level was decreased (p = 0.003) in the MP group. In the LP group, TC level was decreased (p = 0.001), TG level was decreased (p = 0.001), but HDL-c level was not significantly increased. At the end of intervention, quality of life' score was improved in both MP and LP groups (p = 0.037). Decreasing the intake of edible oil n-6/n-3 ratio can improve blood lipids and quality of life. This is significant for the prevention of cardiovascular disease (CVD). It is also essential to note that an excessive reduction of the n-6/n-3 ratio does not further improve the blood lipid metabolism. In addition, the application of perilla oil in nutritional blended oil has particular significance. https://www.chictr.org.cn/indexEN.html, identifier ChiCTR-2300068198.