Treatment Methods Research Articles

ХРОНОФИЗИОТЕРАПИЯ – НОВОЕ НАПРАВЛЕНИЕ В МЕДИЦИНСКОЙ БИОФИЗИКЕ

The study is aimed at solving the issues of increasing the efficiency and safety of treatment for a wide range of diseases based on the developed chronobiological approach to managing the functional state of the body. The approach is based on the following chronobiological patterns: 1. the principle of the rhythm of biological processes in living organisms; 2. the principle of conjugation of bioprocesses and their biorhythms; 3. the principle of chrono-management of living organisms by regulating their biorhythms; 4. the phenomenon of assimilation of external rhythms by living organisms. According to the principle of rhythm, all biological processes in the body have their own biorhythms. This means that bioprocesses and their biorhythms are interdependent and obey the conjugation principle. Therefore, in case of a disease, a violation of bioprocesses in the body is accompanied by a deviation of their biorhythms from the norm – desynchronosis. From this it follows that it is possible to treat diseases not only by pharmacotherapy methods by restoring disturbed bioprocesses, but also by chronophysiotherapy methods by correcting their biorhythms and eliminating desynchronosis. This is the principle of chrono-management of living organisms. However, at present, there is no hardware methods for the treatment of desynchrony on the therapy market. To implement this principle, based on the phenomenon of mastering external rhythms and the principle of conjugation of bioprocesses and their biorhythms, a technology of chronophysiotherapy has been developed. Chronotechnology includes a method of resynchronizing physiotherapy of biorhythms of a sick organism and a chronophysiotherapy apparatus. The frequency component of the EMF is used as an external synchronizer. The apparatus simultaneously implements two treatment functions: chronotherapy and magnetotherapy. The function of chronotherapy implements the developed method of treatment, the therapeutic factor of which is the frequency of EMF from the corresponding range of biorhythms of a healthy organism. And the function of magnetotherapy implements an auxiliary method, the therapeutic factor of which is the magnetic component of the EMF. The device has no side effects on the body and as a result of complex chronomagnetic therapy, the effectiveness of treatment on it reaches 95%.

Local ablative procedures for treatment of thyroid nodules

Thyroid nodules are very frequent in the iodine deficiency regions of central Europe and some of the affected patients are referred for definitive treatment, such as surgery and radioiodine treatment. In recent years nonsurgical and non-radioiodine techniques have been introduced to treat thyroid gland pathologies. These techniques include the probe-based techniques of radiofrequency, microwave and laser application. The only noninvasive technique is high-intensity focused ultrasound. All mentioned techniques have the goal to reduce the volume of the thyroid nodule by application of energy/heat. The knowledge of all techniques and their advantages and risks is necessary to help physicians and patients in making decisions for the appropriate method of treatment of thyroid nodules.

Influence of cervical treatment methods on subsequent vaginal lesions: A study of HPV-related neoplasia

The development of cervical and vaginal intraepithelial neoplasias (CIN and VaIN) is strongly associated with human papillomavirus (HPV) infections, representing key precancerous conditions in women. This study delves into the influence of different cervical treatment methods on the rate of subsequent vaginal neoplasia. It also considers age and menopausal status as risk factors for higher-grade VaIN and the role of persistent HPV infections in the development of new VaIN cases post-treatment. The cohort consisted of 275 female patients treated for CIN, with a follow-up period of six months including HPV and TCT testing. The evaluated treatments included laser therapy, cervical conization, loop electrosurgical excision procedure (LEEP), and radical hysterectomy. Statistical analysis was performed using SPSS 26.0 to determine treatment efficacy, the impact of age and menopausal status, and the relationship between HPV clearance and VaIN outcomes. Radical hysterectomy was linked with a higher recurrence of VaIN. Additionally, patients over 50 years old and those who were postmenopausal were significantly more likely to develop more severe VaIN and persistent HPV infections. Persistence of HPV after treatment was linked to a higher incidence of new VaIN cases. High-risk HPV significantly heightened the recurrence of VaIN, with no significant link found between TCT results and VaIN severity. Therefore, selecting appropriate cervical lesion treatment, considering the patient's age and menopausal status, and managing HPV infections are essential in preventing and managing the risk and progression of VaIN. Radical hysterectomy showed a distinct increase in VaIN incidence, emphasizing the need for individualized clinical assessments.

The usage of a modified straight-leg raise neurodynamic test and hamstring flexibility for diagnosis of non-specific low back pain: A cross-sectional study.

The main purpose of this research study was to compare mean modified straight-leg raise test (mSLR) and hamstring muscle length (HL) between chronic non-specific low back pain (LBP) and healthy subjects to understand the possibility of neuropathic causes in LBP population as it may impact the diagnosis and treatment of LBP. Another purpose was to compare mean mSLR between those with lumbar nerve root impingement and those without as determine by magnetic resonance imaging (MRI). The design of the study is cross sectional and included 32 subjects with ages ranging from 18-50 years old. Clinical exam objective measures were collected such as patient questionnaires, somatosensory tests, HL range of motion, and a mSLR test, and were compared to the findings from a structural lumbar spine MRI. There were no significant differences in mean HL angulation and mSLR angulation between LBP and healthy subjects (p>0.05). There was no significant difference in mean HL by impingement by versus no impingement (38.3±15.6 versus 44.8±9.4, p = 0.08, Cohen's d = 0.50). On the other hand, there was a significant difference in mean mSLR angulation by impingement (57.6.3±8.7 versus 63.8±11.6, p = 0.05, Cohen's d = 0.60). The mSLR test was found to be associated with lumbar nerve root compression, regardless of the existence of radiating leg symptoms, and showed no association solely with the report of LBP. The findings highlight the diagnostic dilemma facing clinicians in patients with chronic nonspecific LBP with uncorrelated neuroanatomical image findings. Clinically, it may be necessary to reevaluate the common practice of exclusively using the mSLR test for patients with leg symptoms. This study may impact the way chronic LBP and neuropathic symptoms are diagnosed, potentially improving treatment methods, reducing persistent symptoms, and ultimately improving disabling effects.

Treatment of vulvar cancer recurrence with electrochemotherapy: a case-control study.

Electrochemotherapy (ECT) is a combined treatment method based on electroporation and simultaneous chemotherapy. In cases where radiotherapy has previously been used, surgery is often the only treatment option for vulvar cancer recurrence with potential resection of clitoris, vagina, urethra or anal sphincter. The unique advantage of ECT is its selectivity for cancer cells while sparing the surrounding healthy tissue. The aim of the study was to compare the ECT treatment of vulvar cancer recurrence for non-palliative purposes with surgical treatment. Eleven patients with single vulvar cancer recurrence were treated with ECT and followed up for 12 months. As a control group, 15 patients with single vulvar cancer recurrence were treated with wide local excision. The following data were collected, analyzed and compared: Age, body mass index, comorbidities, histological type, location and size of vulvar cancer recurrence, treatment history, details of procedures and hospital stay. The probability curves for local tumor control did not differ between the ECT group and the surgical group (p = 0.694). The mean hospital stay and the mean duration of procedure were statistically significantly shorter in the ECT group (p < 0.001). There were no statistically significant differences between the ECT and surgical groups in terms of mean body mass index, associated diseases, previous treatments, presence of lichen sclerosus, p16 status, gradus, anatomical site of the tumor, and type of anesthesia. In this case-control study, treatment of vulvar cancer recurrence with ECT for non-palliative purposes was comparable to surgical treatment in terms of effectiveness. The results need to be confirmed in larger randomized trials.

Exploring sample treatment strategies for untargeted metabolomics: A comparative study of solid phase microextraction (SPME) and homogenization with solid-liquid extraction (SLE) in renal tissue

BackgroundThe selection of the sample treatment strategy is a crucial step in the metabolomics workflow. Solid phase microextraction (SPME) is a sample processing methodology with great potential for use in untargeted metabolomics of tissue samples. However, its utilization is not as widespread as other standard protocols involving steps of tissue collection, metabolism quenching, homogenization, and extraction of metabolites by solvents. Since SPME allows us to perform all these steps in one action in tissue samples, in addition to other advantages, it is necessary to know whether this methodology produces similar or comparable metabolome and lipidome coverage and performance to classical methods. ResultsSPME and homogenization with solid-liquid extraction (Homo-SLE) sample treatment methods were applied to healthy murine kidney tissue, followed by comprehensive metabolomics and lipidomics analyses. In addition, it has been tested whether freezing and storage of the tissue causes alterations in the renal metabolome and lipidome, so the analyses were performed on fresh and frozen tissue samples Lipidomics analysis revealed the exclusive presence of different structural membrane and intracellular lipids in the Homo-SLE group. Conversely, all annotated metabolites were detected in both groups. Notably, the freezing of the sample mainly causes a decrease in the levels of most lipid species and an increase in metabolites such as amino acids, purines, and pyrimidines. These alterations are principally detected in a statistically significant way by SPME methodology. Finally, the samples of both methodologies show a positive correlation in all the analyses. SignificanceThese results demonstrate that in SPME processing, as long as the fundamentals of non-exhaustive extraction in a pre-equilibrium kinetic regime, extraction in a tissue localized area, the chemistry of the fiber coating and non-homogenization of the tissue are taken into account, is an excellent method to use in kidney tissue metabolomics; since this methodology presents an easy-to-use, efficient, and less invasive approach that simplifies the different sample processing steps.

Human umbilical cord mesenchymal stem cells combined with dehydroepiandrosterone inhibits inflammation-induced uterine aging in mice.

With the postponement of women's reproductive age, the difficulty of embryo implantation caused by uterine aging has become a key factor restricting fertility. However, there are few studies on protective interventions for naturally aging uteri. Although many factors cause uterine aging, such as oxidative stress, inflammation, and fibrosis, their impact on uterine function manifests as reduced endometrial receptivity. This study aimed to use a combination of human umbilical cord mesenchymal stem cells (hUC-MSC) and dehydroepiandrosterone (DHEA) to delay uterine aging. The results showed that the combined treatment of hUC-MSCs+DHEA increased the number of uterine glandular bodies and the thickness of the endometrium while inhibiting the senescence of endometrial epithelial cells. This combined treatment alleviates the expression of oxidative stress (ROS, SOD, and GSH-PX) and pro-inflammatory factors (IL-1, IL6, IL-18, and TNF-α) in the uterus, delaying the aging process. The combined treatment of hUC-MSCs+DHEA alleviated the abnormal hormone response of the endometrium, inhibited excessive accumulation and fibrosis of uterine collagen, and upregulated uterine estrogen and progesterone receptors through the PI3K/AKT/mTOR pathway. This study suggests that uterine aging can be delayed through hUC-MSCs+DHEA combination therapy, providing a new treatment method for uterine aging.

Current status and research progress of minimally invasive treatment of glioma

Glioma has a high malignant degree and poor prognosis, which seriously affects the prognosis of patients. Traditional treatment methods mainly include craniotomy tumor resection, postoperative radiotherapy and chemotherapy. Although above methods have achieved remarkable curative effect, they still have certain limitations and adverse reactions. With the introduction of the concept of minimally invasive surgery and its clinical application as well as the development and progress of imaging technology, minimally invasive treatment of glioma has become a research hotspot in the field of neuromedicine, including photothermal treatment, photodynamic therapy, laser-induced thermal theraphy and TT-Fields of tumor. These therapeutic methods possess the advantages of precision, minimally invasive, quick recovery and significant curative effect, and have been widely used in clinical practice. The purpose of this review is to introduce the progress of minimally invasive treatment of glioma in recent years and the achievements and prospects for the future.

Регресс ринофимы на фоне фотодинамической терапии базальноклеточного рака кожи кончика носа

The article describes a case of regression of rhinophyma against the background of photodynamic therapy of basal cell carcinoma of the skin of the nose tip. After a single session of photodynamic therapy using a systemic photosensitizer based on chloride (photoran), there was a significant decrease in the size of the nose (rhinophyma), the disappearance of erythema, puffiness, and the formation of the initial contours of the face of this anatomical area. Despite the marginal recurrence of basal cell carcinoma after six months at the site of previous treatment and a repeat session of photodynamic therapy, after one year of dynamic follow-up, remission of basal cell carcinoma and regression of rhinophyma persist. The described method of treatment is atraumatic, easily reproducible, well tolerated by patients, safe and allows patients with basal cell carcinoma in combination with rhinophyma to achieve complete remission of both diseases.

Evaluation of Ultrasound Screening Method and Prevalence for Developmental Hip Dysplasia In The Central Anatolia

Objectives:This study aimed to assess the frequency and subsequent results of developmental dysplasia of the hip (DDH) in newborns in Central Anatolia who were admitted to Konya City Hospital and evaluate the efficiency of the existing screening and treatment methods in detecting and managing DDH in infants. Methods: Total of 10,650 infants were evaluated who had Graf USG screening in Konya City Hospital. İnfants born at or after 38 weeks of gestation were included, while premature infants were excluded. Additionally, we included infants who underwent USG screening between 30 and 90 days after birth, and whose hip development physiology was adequately visualized and assessed during the USG examination. Results: The study examined 8,695 term infants (52.5% male, 47.5% female) who underwent USG screening between 2020 and 2022. Participants mean gestational age at the time of the first USG examination was 7.94±2.07 weeks. Graf type 1 was higher in males (%97-96,5) and graf type 2 was higher in females (%7,2-7,8). Radiologists prefer to re-examine after 1 month for type 2a(%84,49-82,02) but orthopaedic consultation for type Type-2B, 2C, and type-3. The majority of infants (93.6%) underwent only one USG screening. No patients who continued regular USG control and treatment required surgical treatment requiring osteotomy. Conclusion: USG is an early diagnostic method for developmental hip dysplasia (DDH), which allows for simple treatment options and prevention of complications. It is a simple, inexpensive, and non-invasive method. Our study supports that regular USG screenings in infants eliminate the need for surgical procedures requiring osteotomy.

DIFFERENTIAL DIAGNOSIS OF TUBERCULOSIS AND NON-SPECIFIC PULMONARY INFILTRATS (Lecture)

Following the reformation of healthcare system and the dissolution of the specialty "Phthisiology," the extensive anti-tuberculosis efforts in Ukraine now fall under the purview of family doctors and specialists across various fields. According to the Law of Ukraine “On Overcoming Tuberculosis in Ukraine”, enacted on 14.07.2023 under No. 3269-IX, Paragraph 4 (Article 4), individuals afflicted with tuberculosis or latent tuberculosis infection are entitled to specialized medical care. This includes the treatment of all forms of tuberculosis and associated conditions across a spectrum of healthcare institutions. Compliance with this legal mandate necessitates that doctors of various specialties possess not only proficiency in contemporary tuberculosis treatment methods, which will be facilitated by the regional tuberculosis control center, but also competence in diagnosing tuberculosis in its various presentations. When health issues arise, patients typically seek assistance first from primary care specialists. The “Pulmonary infiltrate syndrome” is an X-ray syndrome characterized by the presence of shadows in the lungs exceeding 1 cm in diameter. There are numerous causes for such changes in the lungs. Given that the lungs are the most common site for tuberculosis, particularly in the form of infiltrative shadows, which may signify not only tuberculosis but also pneumonia, tumors, lung infarction, eosinophilic infiltrate, and other conditions, the question of their differential diagnosis becomes quite relevant. The increasing frequency and subtle clinical presentation of the “Pulmonary infiltrate syndrome” necessitate proficiency in the clinical aspects and diagnosis of its most common manifestations. The key differential diagnostic features that distinguish infiltrative pulmonary tuberculosis from other nonspecific infiltrates include contact with a tuberculosis patient or a history of tuberculosis, often subacute onset, heterogeneous infiltrative shadow in 1, 2, or 6 segments with a connection to the lung root, moderate leukocytosis, lymphopenia, elevated ESR, presence of acid-fast bacilli in sputum or bronchial lavage, specific endobronchitis, positive response to antitubercular therapy, and lack of improvement with other nonspecific treatment methods.

OPerative versus non-opERAtive management of isolated ULNAr diaphyseal fractures (OPERA-Ulna): protocol for a randomized controlled trial.

Isolated fractures of the ulnar diaphysis are uncommon, occurring at a rate of 0.02 to 0.04 per 1,000 cases. Despite their infrequency, these fractures commonly give rise to complications, such as nonunion, limited forearm pronation and supination, restricted elbow range of motion, radioulnar synostosis, and prolonged pain. Treatment options for this injury remain a topic of debate, with limited research available and no consensus on the optimal approach. Therefore, this trial aims to compare clinical, radiological, and functional outcomes of two treatment methods: open reduction and internal fixation (ORIF) versus nonoperative treatment in patients with isolated ulnar diaphyseal fractures. This will be a multicentre, open-label, parallel randomized clinical trial (under National Clinical Trial number NCT01123447), accompanied by a parallel prospective cohort group for patients who meet the inclusion criteria, but decline randomization. Eligible patients will be randomized to one of the two treatment groups: 1) nonoperative treatment with closed reduction and below-elbow casting; or 2) surgical treatment with ORIF utilizing a limited contact dynamic compression plate and screw construct. The primary outcome measured will be the Disabilities of the Arm, Shoulder and Hand questionnaire score at 12 months post-injury. Additionally, functional outcomes will be assessed using the 36-Item Short Form Health Survey and pain visual analogue scale, allowing for a comparison of outcomes between groups. Secondary outcome measures will encompass clinical outcomes such as range of motion and grip strength, radiological parameters including time to union, as well as economic outcomes assessed from enrolment to 12 months post-injury. This trial has been approved by the lead site Conjoint Health Research Ethics Board (CHREB; REB14-2004) and local ethics boards at each participating site. Findings from the trial will be disseminated through presentations at regional, national, and international scientific conferences and public forums. The primary results and secondary findings will be submitted for peer-reviewed publication.

ANALYZING DEVICES AND METHODS FOR ASSESSING THE PRIMARY STABILITY OF ORTHODONTIC MINI-IMPLANTS

When disruptions occur in the mechanisms regulating the eruption of lower jaw molars, it becomes necessary to artificially extract and reposition them within the dentition. Various treatment methods are employed for this purpose, with the primary approach involving traction fixed to teeth or other anchorage elements and bone supports. Skeletal support is preferred to minimize resistance from orthodontic appliances when applying force to the patient's teeth. The utilization of mini-implants for anchorage demonstrates a relatively high success rate, though instances of failures and complications are not unheard of. Potential issues such as stability loss and mini-implant displacement may necessitate relocation or adjustments to treatment strategies, posing challenges for both practitioners and patients. Unlike dental implants, where secondary stability often dictates treatment success, primary stability holds paramount importance for orthodontic mini-implants. Investigating primary stability parameters can significantly impact treatment strategy selection and orthodontic mini-implant loading timelines. Focusing solely on mini-implant torque during placement is inadequate, as it fails to comprehensively gauge real stability. Moreover, the available range of torque indicators for orthodontic mini-implant placement is limited, typically ranging from 5ncm to 10 ncm. Furthermore, the selection of specialized devices for measuring primary stability is limited and necessitates meticulous evaluation.

Let’s open our eyes to the importance of vaginal microbiota. Correlation between dysbiosis and HPV infection: A review

Infections with the human papillomavirus (HPV) are one of the most common sexually transmitted diseases and are the main cause of precancerous changes and cervical cancer development. However, mere infection does not guarantee the development of disease or carcinogenesis. For this to occur, high-risk types of HPV must integrate into the host cell genome, transitioning into a persistent form of infection. Following the discovery of risk factors for HPV infection and factors predisposing infection to a persistent form, the number of studies investigating the correlation between vaginal dysbiosis and infection has significantly increased. Numerous studies document a significant association between the state of vaginal bacterial flora and HPV infection, leading to the development of plentiful studies on infection pathogenesis, risk factors, prevention, and treatment methods using bacteria. In this paper, based on recently published studies and current state of science knowledge, we will outline the topic of vaginal microbiome, emphasize the importance of bacteria inhabiting the vagina for human health, and identify the problem of changes in vaginal microflora. We would like to contribute to the dissemination of knowledge about the vaginal microbiome and general knowledge about taking care of its health. We will also summarize available treatment methods based on bacterial environment and discuss those methods for which research is currently underway or should be initiated.

Limited debridement combined with ReCell® Techniques for deep second-degree burns.

The purpose of this article is to introduce a method that combines limited debridement and ReCell® autologous cell regeneration techniques for the treatment of deep second-degree burn wounds. A total of 20 patients suffered with deep second-degree burns less than 10% of total body surface area (TBSA) who were admitted to our department, from June 2019 to June 2021, participated in this study. These patients first underwent limited debridement with an electric/pneumatic dermatome, followed by the ReCell® technique for secondary wounds. Routine treatment was applied to prevent scarring after the wound healed. Clinical outcomes were scored using the Vancouver Scar Scale (VSS). All wounds of the patients healed completely. One patient developed an infection in the skin graft area and finally recovered by routine dressing changes. The average healing time was 12 days (range: 10-15 days). The new skin in the treated area was soft and matched the colour of the surrounding normal skin and the VSS score ranged from 3~5 for each patient. Of the 20 patients, 19 were very satisfied and 1 was satisfied. This article reports a useful treatment method that combines electric dermatome-dependent limited debridement and the ReCell® technique for the treatment of deep second-degree burn wounds. It is a feasible and effective strategy that is easy to implement and minimally invasive, and it is associated with a short healing time, mild scar formation and little damage to the donor skin area.

The analysis of IVF outcomes after fertility-preserving therapy for endometrial hyperplasia or carcinoma.

This study aimed to evaluate the clinical efficacy of fertility-preserving therapy through in vitro fertilization (IVF) procedures in women who were pathologically diagnosed with endometrial hyperplasia or carcinoma. A retrospective cohort study on fertility-preserving therapy was conducted. Participants/Materials, Setting: A total of 82 women were enrolled who had simple endometrial hyperplasia (SH), complex hyperplasia (CH), complex atypical hyperplasia (CAH), and endometrioid endometrial carcinoma stage IA (EC IA) and underwent IVF at Gangnam CHA fertility center between January 2008 and December 2020. The primary endpoints were oncologic outcomes and subsequent reproductive outcomes of patients who underwent fertility-preserving treatments analyzed by χ2 test (chi-square test) or Fisher's exact test. Of the 82 patients, 33 had a cumulative clinical pregnancy (40.2%), and 25 had a cumulative live birth (30.5%) through IVF procedures following pathologic confirmation of complete remission or non-progressive status. The cumulative clinical pregnancy rates and live birth rates for, SH were 50.0% and 30.0%, for CH were 37.8% and 28.9%, for CAH were 25.0% and 25.0%, and for EC were 38.5% and 38.5%, respectively. There were no significant differences in cumulative clinical pregnancy rates or live birth rates when comparing the four groups. There was a difference in endometrial thickness between MPA treatment group and IUD group (p=0.036); however, there were no significant differences in clinical pregnancy rates among MPA, IUD, and MPA+IUD groups. Because of the retrospective nature of the study, many factors relevant to the treatment decision were not strictly controlled. All endometrial hyperplasia and carcinoma groups had competent cumulative live birth rates by IVF procedures. There may be differences in endometrial thickness depending on the treatment methods, but this does not affect clinical pregnancy rates. Therefore, the fertility-preserving treatment for endometrial hyperplasia and carcinoma is a safe and feasible method that results in good IVF outcomes.

Emerging trends in POME treatment and applications: chemical and biotechnological aspects

Globally, environmental challenges are growing more and more significant. Changes in soil have been caused by the years-long discharge and careless disposal of palm oil mill effluent (POME). A systematic review explored emerging trends in POME treatment and applications, with a focus on recent, innovative methods for POME treatment with biological and chemical treatment technologies, chemical and biotechnological approaches. The review highlighted several key findings, including the efficiency and cost-effectiveness of these approaches, their ability to reduce environmental impacts, and their potential to recover resources such as energy and nutrients. Quantitative information on the efficacy of these approaches was also provided. Based on these findings, the review concludes that the aforementioned approaches can significantly improve POME treatment and offer a promising way to reduce environmental impacts and recover resources. However, further research is needed to optimize and scale up these approaches, as well as to assess their long-term sustainability. In addition, it is important to consider the social, economic, and environmental factors that may affect the successful implementation of these approaches.

Oral Administration Properties Evaluation of Three Milk-derived Extracellular Vesicles Based on Ultracentrifugation Extraction Methods.

Milk-derived extracellular vesicles (M-EVs) are low-cost, can be prepared in large quantities, and can cross the gastrointestinal barrier for oral administration. However, the composition of milk is complex, and M-EVs obtained by different extraction methods may affect their oral delivery. Based on this, we propose a new method for extracting M-EVs based on cryogenic freezing treatment (Cryo-M-EVs) and compare this method with the previously reported acetic acid treatment (Acid-M-EVs) method and the conventional ultracentrifugation method (Ulltr-M-EVs). The new method simplifies the pretreatment step and achieves 25-fold and 2-fold higher yields than Acid-M-EVs and Ulltr-M-EVs. And it was interesting to note that Cryo-M-EVs and Acid-M-EVs had higher cellular uptake efficiency, and Cryo-M-EVs presented the best transepithelial transport effect. After oral administration of the three M-EVs extracted by three methods in mice, Cryo-M-EVs effectively successfully crossed the gastrointestinal barrier and achieved hepatic accumulation, whereas Acid-M-EVs and Ultr-M-EVs mostly resided in the intestine. The M-EVs obtained by the three extraction methods showed a favorable safety profile at the cellular as well as animal level. Therefore, when M-EVs obtained by different extraction methods are used for oral drug delivery, we can utilize their accumulation properties at different sites to better deal with different diseases. This article is protected by copyright. All rights reserved.

Traditional cooking methods decreased the allergenicity of egg proteins.

Egg allergy is one of the most common food allergies globally. This study aimed to assess the impact of four traditional cooking methods on the allergenicity of egg proteins using a comprehensive strategy, including simulated gastrointestinal digestion in vitro, serology experiments, a rat basophilic leukemia (RBL)-2H3 cell degranulation model, and a passive cutaneous anaphylaxis (PCA) mice model, and the structure changes were detected by circular dichroism (CD)spectra and ultraviolet (UV) spectra. The results showed that the processed egg proteins were more readily digested compared to raw egg proteins. The serological experiments revealed a significant reduction in immunoglobulin E binding of egg proteins after thermal treatments (p<0.05), particularly after frying. Subsequently, the RBL-2H3 cell degranulation experiment demonstrated a marked decrease in the level of egg allergens-induced β-hexosaminidase release after cooking (p<0.05). Moreover, the results from the PCA mice model indicated that the increase in vascular permeability was effectively relieved in the treated groups, especially in frying group (p<0.05). Additionally, the α-helix and β-turn contents of processed egg proteins were significantly decreased (p<0.05) compared with native egg proteins. The UV spectra findings showed that all cooking treatments caused significant alterations in the tertiary structure, and fluorescence analysis indicated that cooking decreased the surface hydrophobicity of egg proteins. In conclusion, four traditional cooking methods reduced the allergenicity of egg proteins, particularly frying, and this reduction was associated with structural changes that could contribute to the destruction or masking of epitopes of egg allergens. PRACTICAL APPLICATION: Egg allergy has a serious impact on public health, and there is no ideal treatment method at present. This study demonstrated that four traditional cooking methods (boiling, steaming, baking, and frying) reduced the allergenicity of egg proteins, especially frying, and the results will provide a basis for the development of hypoallergenic egg products.

Correlative analysis of different treatments of persistent occipitotransverse position on the outcome for mother and infant.

To explore the clinical feasibility of different treatment methods for persistent occipitotransverse position and the influence on maternal and infant complications. During the trial of vaginal delivery from April 2020 to March 2023 in our hospital, the cervix was fully dilated and the presentation was located at +2 station. Ninety-six pregnant women with fetal presentation at +4 station, occipitotransverse fetal position, maternal complications, abnormalities in the second stage of labor, and or fetal distress were divided into two groups: 65 patients with Kielland forceps vaginal delivery and 31 patients underwent emergency cesarean section. The delivery time, vaginal laceration rate, postpartum blood loss volume, puerperal infection rate, neonatal birth injury rate, and neonatal 1 min Apgar scores were analyzed. The delivery outcomes and maternal and neonatal complications of 96 pregnant women were analyzed: the application of Kielland forceps delivery time was shorter, while the vaginal laceration rate, postpartum hemorrhage, puerperal infection rate were significantly lower than that of patients undergoing emergency cesarean section and the neonatal 1 min Apgar score was higher than that of emergency cesarean section group (p < 0.05). It was clinically appropriate to use Kielland forceps in vaginal delivery when the persistent occipitotransverse position was present and delivery needed to be expediated. Use of Kielland forceps can shorten the delivery time, improve the success rate of vaginal delivery and reduce the complications of mothers and infants.