No abstract

Triptolide, a diterpenoid isolated from the Chinese herb Tripterygium wilfordii Hook F, has been demonstrated to be effective in the treatment of a variety of autoimmune diseases. T helper type 17 (Th17) cells represent a novel subset of CD4+ T cells involved in the immunopathogenesis of autoimmune diseases. Currently, the effects of triptolide on the differentiation of Th17 cells remain unclear. Here, we found that triptolide significantly inhibited the generation of Th17 cells from murine splenocytes and purified CD4+ T cells in a dose‐dependent manner. The suppressive effects of triptolide were persistent even after it had been removed from cell cultures. Importantly, triptolide inhibited the transcription of interleukin‐17 (IL‐17) mRNA and IL‐6‐induced phosphorylation of STAT3, a key signalling molecule involved in the development of Th17 cells. Moreover, these suppressive effects of triptolide on Th17 differentiation were not due to cytotoxicity of triptolide because the numbers of viable cells had no significant difference between triptolide‐treated and non‐triptolide‐treated cells. In vivo studies demonstrated that the treatment of collagen‐induced arthritis (CIA) mice with triptolide reduced arthritis scores and swollen degree of joints. At the same time, the levels of collagen type II (CII)‐specific IL‐17 production and the percentages of CII‐specific IL‐17+CD4+ T cells in the cells from draining lymph nodes and spleens were significantly reduced in CIA mice treated with triptolide. These results suggested that triptolide displayed an immunosuppressive effect on CIA by down‐regulating CII‐specific Th17 cells. Taken together, our results may provide a new light on the potential mechanism of the immunosuppressive and anti‐inflammatory effects of triptolid.

Background: Using data from the global burden of disease (GBD) between 1990 and 2019 to report the leading etiological factors and hazards for liver cancer by HBV (LCHB), HCV (LCHC), alcoholic use (LCAL), NASH (LCNA), and other causes (LCOT). Method:The estimated annual percentage change (EAPC) and age-standardized incidence rate (ASR) in different districts, sex, and age are used to quantify the change of etiologies of liver cancer. Age-period-cohort models were performed to predict the primary liver cancer incidence and case numbers.Results: Based on the GBD database of the whole world for the five etiologies of liver cancer in 2019, the percentage of incidence of LCAL, LCHB, LCHC, LCNA, and LCOT are 18.4%, 41%, 28.5%, 6.8%, and 5.3%, respectively. Fiver etiologies of liver cancer show gender differences, with LCHB and LCAL being more prevalent in men, and LCHC, LCNA being more prevalent in women. Besides, live cancer of males is because of alcohol using and smoking, while the reason of liver cancer of females is drug use, high BMI and high fasting plasma glucose. Interestingly, the incidence of LCHC in women over 85 years old, LCNA in women over 75 years old, and LCOT in women over 75 years old were all higher than that in men.According to the future prediction, the incidence rate of liver cancer itself, as well as the five causes of liver cancer, tends to decrease gradually after 2019, while the incidence rate of LCNA in males will continue to increase until 2025. Conclusions:The incidence of liver cancer has been increasing and its major causes vary considerably at global, regional, or national levels, also vary by gender and age group.

Background Dysphagia is a common condition after stroke, and it is associated with many complications. Early and effective treatments are essential to the prognosis of patients with dysphagia. We aimed to evaluate the effects and safety of capsaicin combined with ice stimulation in patients with dysphagia after stroke. Methods Patients with dysphagia admitted to our hospital from December 2017 to December 2019 were included. The control group received the ice stimulation, and the experimental group received the combined capsaicin and ice stimulation. The grade of water swallowing test (WST), standard swallowing assessment (SSA) scores and the serum substance P level was compared between control (ice only) and experimental group (capsaicin plus ice). Results No differences before treatment and significance following treatment in each group (before and after) and between groups (capsaicin plus ice vs ice only) were found (all P > .05); the SSA scores were significantly reduced after intervention for both groups (all P < .001), and after intervention, SSA score in experimental group was significantly less than that of control group (P < .001). After intervention, the number of patients graded as WST level I‐II in experimental group was significantly more than that of control group (P < .001); the serum substance P level was significantly increased after intervention for both groups (all P < .05), and after intervention, the serum substance P level in experimental group was significantly higher than that of control group (P = .007). Conclusions The combined use of capsaicin with ice stimulation is beneficial to the recovery of swallowing function of patients with dysphagia, which should be included into the clinical practice.

BackgroundGum chewing has been reported to enhance the intestinal function recovery after caesarean section, current perspectives and practice guidelines vary widely on the use of gum chewing, more studies on the role of gum chewing after caesarean section are needed.MethodsWe performed a comprehensive, systematic meta-analysis of randomized controlled trials (RCTs) on the efficacy of gum chewing after caesarean section. Studies were identified by searching EMBASE et al database (until June 30, 2016). Summary odd ratios or weighted mean differences with 95% confidence intervals were calculated for each outcome with fixed- or random-effects model.ResultsTen RCTs with a total of 1659 women were included in our meta-analysis. Gum chewing provided significant benefits in reducing the time to first passage of flatus, first defecation, first bowel sound, first bowel movement and the length of hospital stay, but not in the time to first feeling of hunger.ConclusionsGun chewing hastens the intestinal function recovery after caesarean section and offers a safe and inexpensive option. High-quality and larger-scale RCTs are still warranted to clarify the role of gum chewing in intestinal function recovery after caesarean section.

The routine humidification of oxygen in low-flow oxygen therapy is not justifiable and non-humidified oxygen tends to be more beneficial. However, considering that the quality of most included studies is poor, rigorously designed, large-scale randomized controlled trials are still needed to identify the role of non-humidified oxygen therapy.

BackgroundPrimary angiosarcoma of the spleen is a rare mesenchymal malignant tumor of vascular origin often with a poor prognosis, due to its high metastatic potential. This disease often presents with atraumatic rupture and lethal hemorrhage.Case presentationWe report a case of a 65-year-old man who presented with abdominal pain, anemia, thrombocytopenia, and palpable abdominal mass with unstable blood pressure. Laparotomy revealed a huge actively bleeding spleen, thus splenectomy was performed. Some liver metastasis foci were also found during the procedure. Histopathology diagnosis of the removed spleen was primary splenic angiosarcoma. The patient was discharged on the 10th day post operation with no complication.ConclusionsSplenic angiosarcoma should be considered one of the differential diagnoses in patients with spleen parenchymal lesions. Definitive diagnosis requires laparotomy followed by splenectomy. In the majority of the patients with spleen angiosarcoma, metastatic diseases have already occurred at the time of laparotomy, so splenectomy is an approach more for diagnostic purpose rather than curative purpose.

Recently, pocket green spaces (PGS), i.e., small green spaces, have attracted growing attention for their various ecological and social services. As a crucial part of urban green spaces in high-density urban areas, PGS facilitates recreation and relaxation for neighborhoods and thus improves the livability of cities at the local scale. However, whether and how the PGS cools the urban heat island effect is still unclear. This research was performed in the highly developed areas of the city of Shanghai during hot summer daytime. We applied a set of cooling effect indicators to estimate the cooling extent, cooling intensity, and cooling efficiency of PGS. We further examined whether and how landscape features within and surrounding the PGS influence its cooling effects. The results showed that 90% of PGS are cooler than their surroundings. Among the landscape features, the land surface temperature of PGS logarithmically decreased with its area, and the maximum local cool island intensity and maximum cooling area logarithmically increased with the area of PGS. The vegetation types and their composition within the PGS also influenced their surface temperature and the cooling effect. The PGS dominated by tree-shrub-grass showed the highest cooling efficiency. The surrounding landscape patterns, especially the patch density and the landscape shape index, influence the cooling effect of PGS at both class and landscape levels. These findings add new knowledge on factors influencing the cooling effect of PGS, and provide the biophysical theoretical basis for developing nature-based cooling strategies for urban landscape designers and planners.