non-EA Research Articles

Characterization and cluster analyses of elderly asthma in comparison with nonelderly patients with asthma in Japan

BackgroundAsthma is a heterogeneous disease with multiple phenotypes that are useful in precision medicine. As the population ages, the elderly asthma (EA, aged ≥ 65 years) population is growing, and EA is now a major health problem worldwide. ObjectiveTo characterize EA and identify its phenotypes. MethodsIn adult patients with asthma (aged ≥ 18 years) who had been diagnosed with having asthma at least 1 year before study enrollment, 1925 were included in the NHOM-Asthma (registered in UMIN-CTR; UMIN000027776), and the data were used for this study, JFGE-Asthma (registered in UMIN-CTR; UMIN000036912). Data from EA and non-EA (NEA) groups were compared, and Ward's minimum-variance hierarchical clustering method and principal component analysis were performed. ResultsEA was characterized by older asthma onset, longer asthma duration and smoking history, more comorbidities, lower pulmonary function, less atopic, lower adherence, and more hospital admissions because of asthma. In contrast, the number of eosinophils, total immunoglobulin E level, oral corticosteroid use, and asthma control questionnaire scores were equivalent between EA and NEA. There were 3 distinct phenotypes in EA, which are as follows: EA1: youngest, late onset, short duration, mild; EA2: early onset, long duration, atopic, low lung function, moderate; and EA3: oldest, eosinophilic, overweight, low lung function, most severe. The classification factors of the EA phenotypes included the age of onset and asthma control questionnaire—6. Similarities were observed between EA and NEA phenotypes after principal component analysis. ConclusionThe EA in Japan may be unique because of the population's high longevity. Characterization of EA phenotypes from the present cohort indicated the need for distinct precision medicine for EA. Trial RegistrationJFGE-Asthma registered in UMIN-CTR (https://www.umin.ac.jp/ctr/); UMIN000036912.

Epidural analgesia during labor and its optimal initiation time-points: A real-world study on 400 Chinese nulliparas.

Recent research has suggested that 6 cm of cervical dilation should be the threshold for the active labor phase, and it has confirmed that epidural analgesia (EA) is a safe method of pain relief during labor. However, the evidence provided for these findings comes mainly from randomized controlled clinical trials (RCTs), which suffer from the limitation of real-world generalizability.To test the generalizability of the conclusions from these previous RCTs, we conducted a prospective cohort, real-world study (RWS) on 400 Chinese term nulliparas. A total of 200 of the participants (the EA group) received EA upon request. The participants in the EA group were further subdivided as follows according to their cervical dilation when the EA administration was initiated (CDE): [EA1 group (CDE < 3 cm), EA2 group (3 cm ≤ CDE < 6 cm), and EA3 group (CDE ≥ 6 cm)]. We compared the labor duration of the EA group versus the non-EA (NEA) group, and the NEA group versus the 3 EA subgroups. We also compared delivery outcomes between the EA and NEA groups.The median total labor duration for the EA group [676 (511–923) minutes] was significantly longer than that of the NEA group [514 (373–721) minutes] (P < 0.001). The median durations of both the first- and second-stages of labor for the EA group [600 (405–855) minutes, 68 (49–97) minutes] were longer than those of the NEA group [420 (300–630) minutes, 50 (32–85) minutes] (P < .001, P < .001)]. In addition, the median total labor durations in both the EA1 [720 (548–958) minutes] and EA2 groups [688 (534–926) minutes] were longer than in the NEA group (P < .001 and P < .001, respectively), and the first- and second-stage labor durations of these subgroups were similar to their total labor durations. A Cox regression analysis showed that EA was associated with longer first-stage labor [hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.42–0.71, P < .001] and longer second-stage labor (HR 0.66, 95% CI 0.51–0.85, P = .001). The delivery modes and neonatal outcomes between the EA and NEA groups were not statistically different, however.Our findings suggest that EA administered before a cervical dilation of 6 cm may be associated with longer total, first-, and second-stage labor durations compared with no EA, while later EA administration is not. In addition, though EA prolongs labor duration, it does not impact delivery outcomes. These results confirm the significance of a 6 cm cervical dilation threshold in real-world labor settings.

The effect of stimulation at Zusanli on pulmonary microvascular endothelial cells of septic rats

Objective To investigate the protecting effect and mechanisms of electroacupuncturing Zusanli(ST36) on pulmonary microvascular endothelial cell(PMVEC) of septic rat. Methods One hundred and eight male Sprague-Dawley rats were randomly divided into 6 groups(n=18): sham group(group Sham), sepsis group (group LPS), acupuncture non-acupoint stimulation group (group non-EA), bilateral electroacupuncture Zusanli group(group EA), bilateral cervical vagotomy after sepsis group (group VGX), bilateral cervical vagotomy thus electroacupunctureing Zusanli group (group VGX/EA). Abdominal aortic blood samples were taken 0.8 ml at 3, 6, 9 h to measure plasma tumor necrosis factor-α(TNF-α) expression level. Lung tissues were collected to investigate the expression of Src-suppressed C kinase substrate (SSeCKS) mRNA and E-selection mRNA. The pulmonary microvascular endothelial cells were observed by transmission electron microscope at 6 h after LPS exposure. Results The expression levels of TNF-α in plasma, as well as SSeCKS mRNA and E-selection mRNA expression levels in lung tissue were obviously higher in other groups than the expression levels of these molecules in group Sham (P 0.05). The expression levels of TNF-α, SSeCKS mRNA and E-selection mRNA in group EA were markedly lower than the expression levels in group LPS(P 0.05). Transmission electron microscopy observed EA at Zusanli distinctly reduced the dysfunction of microvascular endothelial cells. Conclusions Electroacupuncturing Zusanli can protect LPS induced PMVEC injury and exert protective effects via activation of cholinergic anti-inflammatory pathway (CAP). Key words: Zusanli; Electroacupuncture; Sepsis; Pulmonary microvascular endothelial cell

Sputum TWEAK expression correlates with severity and degree of control in non-eosinophilic childhood asthma.

Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is known to play a role in the pathogenesis of various inflammatory diseases. However, no study has been performed on childhood asthma. Ninety-five children with asthma and 78 controls aged 5-18years were included. Sputum induction, pulmonary function test (PFT), and methacholine challenge test were performed. The subjects were divided into the eosinophilic airway (EA) and non-EA (NEA) groups based on sputum analysis and into the high and low TWEAK groups according to the TWEAK cutoff level (263.0pg/mL). TWEAK in induced sputum supernatant was measured through enzyme-linked immunosorbent assay. Children with asthma had higher TWEAK levels than healthy controls (493.0 [157.1-904.3] vs 118.2 (67.5-345.5) pg/mL, P<.001). Sputum TWEAK levels were significantly correlated with PFT parameters reflecting airway obstruction. This association was particularly prominent in subjects with NEA inflammation. Significant differences in FEF25-75 (maximum mid-expiratory flow, % predicted; P=.017), AX (reactance area; P<.001), R5-R20 (difference between resistance at 5 and 20Hz; P=.025), and X5 (reactance at 5Hz, % predicted; P<.001) were noted between the high and low TWEAK groups within the NEA group. Sputum TWEAK level also showed significant positive correlations with asthma severity (r=.358, P=.001) and control status (r=.470, P<.001), distinctively in subjects with NEA inflammation. Airway TWEAK may play a role in small airway inflammation especially in children with non-eosinophilic asthma.

Exercise Addiction and Psychophysiological Health in Korean Collegiate Students

This study was carried out with collegiate students who took part in an exercise program for 1 year. An exercise addiction (EA) questionnaire was used to classify EA and non-EA (NEA) groups. Exercise dependence (ED), compulsive exercise (CE), and obligatory exercise (OE) questionnaires were used to validate the EA results. A total of 38 male and 37 female college students were selected as the subjects for this study to investigate the effects of EA on psychophysiological health. The psychophysiological health variables were composed of depression, stress, body composition, and muscular joint health. This study showed that EA was significantly associated with ED (r = 0.746; P = 0.001), CE (r = 0.644; P = 0.001), and OE (r = 0.731; P = 0.001), respectively. Although there were no significant differences between EA groups and NEA groups for both males and females on depression (Z = − 0.813; P = 0.416 and Z = − 0.148; P = 0.882, respectively), physical stress (Z = − 0.777; P = 0.437 and Z = −0.074; P = 0.941, respectively), and emotional stress (Z = − 1.035; P = 0.300 and Z = − 0.573; P = 0.567, respectively), the elbow and knee joint functions of EA males were significantly higher compared with those of NEA males. However, the variables of body composition in EA females were not significantly different from those of NEA females. Being addicted to exercise for 1 year resulted in negative effects on the psychological health in both genders, while it had a negative effect on physical health for women only.

Sputum basophils are increased in eosinophilic asthma compared with non-eosinophilic asthma phenotypes.

Sputum basophil numbers are increased in allergic asthmatics, but it is unclear what role airway basophils play in "TH2-low" asthma phenotypes. Using flow cytometry, we found that basophils were significantly increased in all asthmatics (n=26) compared with healthy controls (n=8) (P=0.007) with highest levels observed in eosinophilic asthma (EA); median 0.22%, IQR 0.11%-0.47%; n=14) compared with non-EA (NEA) (0.06%, 0.00%-0.20%; n=12; P<0.05). In asthmatics, basophils were positively correlated with sputum eosinophils (r=0.54; P<0.005) and inversely with sputum neutrophils (r=-0.46: P<0.05), but not with FEV1 (% predicted), FEV1 /FVC or bronchodilator reversibility. In a subgroup initially identified as inadequately controlled asthma (n=7), there was a trend (P=0.08) towards a reduction in sputum basophils following increased inhaled corticosteroid (ICS) treatment. Our findings suggest that basophils may be particularly important in eosinophilic asthma and that sputum basophil assessment could be a useful additional indicator of "TH2-high" asthma.

Гетерогенность и жизнеспособность семян NONEA DECURRENS (C.A. Mey) (G. Donfill) (BORAGINACEAE) в популяции предгорий Дагестана

Гетерогенность и жизнеспособность семян NONEA DECURRENS (C.A. Mey) (G. Donfill) (BORAGINACEAE) в популяции предгорий Дагестана

Risk factors for emergence agitation in patients after general anesthesia

Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia. Key words: Anesthesia, general; Anesthesia recovery period; DYSPHORIA; Risk factor; Postoperative complication

Effects of eletro-acupuncturing at Zusanli point on coagulation and fibrinolysis in septic rats

Objective To investigate the effect of the electrical stimulation Zusanli (ST36) on coagulation and fibrinolysis in septic rats.Methods 192 male SD rats were randomly divided into six groups:saline group ( SHAME ),lipopolysaccharide ( LPS ) group,non-acupuncture stimulation group (non-EA),electrical stimulation Zusanli group (EA),vagotomy group (VGX),bungarotoxin group ( α-BGT).Six animals of every four time points [ before injection of LPS (0),2,4 and 6 h after injection]were killed after abdominal aortic blood was collected.The plasma was detected by enzyme linked immunosorbent assay (ELISA) for tumor necrosis factor-α (TNF-α),D-dimer,plasminogen activator inhibitor-Ⅰ (PAI-I) and tissue-type plasminogen activator (t-PA) levels,and the chromogenic substrate assay for antithrombin Ⅲ( AT-Ⅲ ) activity.Results At the 2nd h after injection of LPS,as compared with EA group (268.64 ±5.48) ng/L,the levels of plasma TNF-α in LPS group (332.71 ±8.23) ng/L and VGX group (449.70 ± 13.74) ng/L,and α-BGT group (448.89 ± 16.50) ng/L were significantly increased (P ＜0.05) ; At the 4th h,as compared with EA group (487.21 ±5.42) ng/L,the levels of plasma PAI in LPS group (681.27 ± 7.72) ng/L and VGX group (776.29 ± 3.23 ) ng/L,and e-BGT group (769.97 ± 5.50)ng/L were significantly increased ( P ＜ 0.05) ; At the 2nd h after injection of LPS,as compared with EA group (10.83 ±0.12) ng/L,the levels of plasma t-PA in LPS group (22.51 ± 0.47) ng/L and VGX group (27.10 ± 0.30) ng/L,and α-BGT group (27.01 ± 0.57 ) ng/L were significantly increased (P ＜0.05) ; At the 2nd h after injection of LPS,as compared with EA group (29.47 ± 3.58) ng/L,the levels of plasma D-dimer in LPS group (50.94 ±3.33) ng/L and VGX group (73.48 ±4.45) ng/L,and α-BGT group ( 70.10 ± 2.80 ) ng/L were significantly increased ( P ＜ 0.05 ) ; as compared with EA group (426.78 ±3.07) ng/L,the levels of plasma AT-Ⅲ in LPS group (368.76 ± 13.83) ng/L and VGX group (244.69 ±4.88 ) ng/L,and α-BGT group (241.85 ± 5.51 ) ng/L were significantly increased (P ＜0.05).Conclusion Electrical stimulation Zusanli can not only inhibit plasma levels of TNF-α but also can reduce inflammation,coagulation and fibrinolytic dysfunction in septic rats. Key words: Sepsis; Zusanli; Coagulation; Fibrinolysis; Electro-acupuncturing

A using of biometric methods for the delineation of floral units on the plant

On the base of the using of biometric analysis of linear dimensions of the leaves, stipules, bracts and bracteoles in the Brassicaceae (Arabidopsis thaliana, Matthiola longipetala, Lobularia maritime), Lamiaceae (Lamium purpureum, Salvia tesquicola) and Boraginaceae (Cynoglossum offisinale, Echium vulgare, Nonea pulla), it has found that the linear dimensions of the leaves and bracts are changed in a similar pattern, which is different from the pattern of change of the stipules and bracteole. In this regard, the biometric analysis of the linear dimensions of the leaves on the shoot can be used as an additional criterion for establishing of the boundaries and composition of floral pieces, as well as for the homologation of shoot elements.

Performance characteristic comparison of two commerical kits for anti-HCV confirmatory test

Objective To detect anti-HCV in serum of hepatic disease patients by performing the confirmatory test, and further to confirm HCV infection. Methods Two recombinant immunoblot assays (CWT and CHIRON RIBA HCV 3.0 Strip Immunoblot Assay) were used respectively to detect anti-HCV in 477 human serum samples, which comprised 350 HCV-infected patients' specimens, 7 none-A none-E hepatitis specimens, 30 HBV-infected patients' specimens, 30 hepatitis E virus infected patients'specimens, and 60 specimens drawn from blood donors. The latter three groups served as controls. Results A total of 120 control non-HCV-infected patients' specimens were negative when tested by both assays. Among 350 HCV-infected patients, 341 were positive and 9 were indeterminated by CWT assay; 343 were positive and 7 were indeterminated by CHIRON RIBA HCV 3. 0 SIA. Seven none-A none-E hepatitis specimens tested by both assays turned out to be 2 positive, 4 negative and 1 indeterminate. The consistency rate of these two assays was 99. 16% (Kappa=0.98). Conclusion CWT assay is highly coherent with CHIRON RIBA HCV 3.0 SIA assay in the methodology of anti-HCV antibody detection, which can be applied in the determination of HCV infection among none-A none-E hepatitis patients. Key words: Hepatitis C; Hepatitis C antibodies; Immunoblotting