Twin Pregnancy with Gastroschisis in Both Twins

SUMMARYObjectiveGastroschisis is a congenital malformation characterized by an abdominal wall defect located laterally to a normal umbilicus. The cause of gastroschisis is unknown, but most authors consider it exogenous. We describe the case of a woman with a twin pregnancy in which both twins had gastroschisis.Case ReportA 17-year-old primiparous female was referred to our institution because of a twin pregnancy, with one twin diagnosed with gastroschisis at 34 weeks of gestation. Unfortunately, gastroschisis was noted in both twins, but no other anomalies were observed under level II sonographic evaluation. The twins were delivered by cesarean section at 36+weeks of gestation because of preterm labor and breech presentation of one fetus. Both twins presented with a 3-cm abdominal wall defect located to the right side of the umbilicus and a large portion of the bowel protruding that was not covered by membrane. Histopathology of the placenta revealed that the twins were diamniotic monochorionic. Chromosomal analysis of cord blood showed normal karyotype (46, XX) in both newborns.ConclusionThe cause of gastroschisis is unknown, although possible exogenous causes have been studied. The diagnosis of gastroschisis in twin pregnancy is always in late gestation. Therefore, maternal serum alpha feto-protein screening and a detailed prenatal ultrasound evaluation are recommended in multifetal pregnancies

Oral Rg1 supplementation strengthens antioxidant defense system against exercise-induced oxidative stress in rat skeletal muscles

BACKGROUND: Previous studies reported divergent results on nutraceutical actions and free radical scavenging capability of ginseng extracts. Variations in ginsenoside profile of ginseng due to different soil and cultivating season may contribute to the inconsistency. To circumvent this drawback, we assessed the effect of major ginsenoside-Rg1 (Rg1) on skeletal muscle antioxidant defense system against exhaustive exercise-induced oxidative stress. METHODS: Forty weight-matched rats were evenly divided into control (N = 20) and Rg1 (N = 20) groups. Rg1 was orally administered at the dose of 0.1 mg/kg bodyweight per day for 10-week. After this long-term Rg1 administration, ten rats from each group performed an exhaustive swimming, and remaining rats considered as non-exercise control. Tibialis anterior (TA) muscles were surgically collected immediately after exercise along with non-exercise rats. RESULTS: Exhaustive exercise significantly (p<0.05) increased the lipid peroxidation of control group, as evidenced by elevated malondialdehyde (MDA) levels. The increased oxidative stress after exercise was also confirmed by decreased reduced glutathione to oxidized glutathione ratio (GSH/GSSG ratio) in control rats. However, these changes were completely eliminated in Rg1 group. Catalase (CAT) and glutathione peroxidase (GPx) activities were significantly (p<0.05) increased by Rg1 in non-exercise rats, while no significant change after exercise. Nevertheless, glutathione reductase (GR) and glutathione S-transferase (GST) activities were significantly increased after exercise in Rg1 group. CONCLUSIONS: This study provide compelling evidences that Rg1 supplementation can strengthen antioxidant defense system in skeletal muscle and completely attenuate the membrane lipid peroxidation induced by exhaustive exercise. Our findings suggest that Rg1 can use as a nutraceutical supplement to buffer the exhaustive exercise-induced oxidative stress

Helicobacter pylori GmhB enzyme involved in ADP-heptose biosynthesis pathway is essential for lipopolysaccharide biosynthesis and bacterial virulence

Helicobacter pylori infection is linked to serious gastric-related diseases including gastric cancer. However, current therapies for treating H. pylori infection are challenged by the increased antibiotic resistance of H. pylori. Therefore, it is in an urgent need to identify novel targets for drug development against H. pylori infection. In this study, HP0860 gene from H. pylori predicted to encode a D-glycero-D-manno-heptose-1,7-bisphosphate phosphatase (GmhB) involved in the synthesis of ADP-L-glycero-D-manno-heptose for the assembly of lipopolysaccharide (LPS) in the inner core region was cloned and characterized. We reported HP0860 protein is monomeric and functions as a phosphatase by converting D-glycero-D-manno-heptose-1,7-bisphosphate into D-glycero-D-manno-heptose-1-phosphate with a preference for the β-anomer over the α-anomer of sugar phosphate substrates. Subsequently, a HP0860 knockout mutant and its complementary mutant were constructed and their phenotypic properties were examined. HP0860 knockout mutant contained both mature and immature forms of LPS and could still induce significant IL-8 secretion after gastric AGS cell infection, suggesting other enzymatic activities in HP0860 knockout mutant might be able to partially compensate for the loss of HP0860 activity. In addition, HP0860 knockout mutant was much more sensitive to antibiotic novobiocin, had decreased adherence abilities, and caused less classic hummingbird phenotype on the infected AGS cells, indicating H. pylori lacking HP0860 is less virulent. Furthermore, the disruption of HP0860 gene altered the sorting of cargo proteins into outer membrane vesicles (OMVs). The above findings confirm the importance of HP0860 in LPS core biosynthesis and shed light on therapeutic intervention against H. pylori infection

DFT Reinvestigation of DNA Strand Breaks Induced by Electron Attachment

The benchmark study of DFT methods on the activation energies of phosphodiester C3′–O and C5′–O bond ruptures and glycosidic C1′–N bond ruptures induced by electron attachment was performed. While conventional pure and hybrid functionals provide a relatively reasonable description for the C1′–N bond rupture, they significantly underestimate the energy barriers of the C–O bond ruptures. This is because the transition states of the later reactions, which are characterized by an electron distribution delocalized from the nucleobase to sugar–phosphate backbone, suffer from a severe self-interaction error in common DFT methods. CAM-B3LYP, M06-2X, and ωB97XD are the top three methods that emerged from the benchmark study; the mean absolute errors relative to the CCSD­(T) values are 1.7, 1.9, and 2.2 kcal/mol, respectively. The C–O bond cleavages of 3′- and 5′-dXMP^•–, where X represents four nucleobases, were then recalculated at the M06-2X/6-31++G**//M06-2X/6-31+G* level, and it turned out that the C–O bond cleavages do not proceed as easily as previously predicted by the B3LYP calculations. Our calculations revealed that the C–O bonds of purine nucleotides are more susceptible than pyrimidine nucleotides to the electron attachment. The energies of electron attachment to nucleotides were calculated and discussed as well

Two Chinese Herbal Regimens Safe for the Elderly on Inhibiting Liver and Bladder Tumor Cell Growth and Regulating Gene Expression

Background: Cancers have become one of the most lethal diseases in elders. In traditional Chinese medicine, Tan-Chih-Hsiao-Yao-San (TCHYS) and Long-Daan-Shiah-Gan-Tang (LDSGT) are used to treat cancers. However, the growth-inhibitory effects and gene expression profiles of these drugs on cancer cells are still unclear. Methods: This study assessed the effects of TCHYS and LDSGT on viability of liver and bladder tumor cells, and bladder TCCSUP cells were further subjected to profile gene expression patterns with microarray technology for identifying gene candidates that may be involved in the tumorigenesis. Results: The results revealed that both drugs significantly eliminated the growth of Chang liver and three hepatoma cells. On the contrary, the embryonic liver WRL68 cells showed less response to the treatments, whereas the control agent genistein had much higher inhibitory effect in WRL68 cells than in the other hepatoma cells. Both TCHYS and LDSGT, as well as cisplatin and paclitaxel, exhibited dose-dependent suppression on the viability of all bladder cancer cells. To characterize the possible regulation for such effects, the profiling of gene expression was performed with complementary DNA chips. When bladder transitional cell carcinoma (TCC) TCCSUP cells were treated with TCHYS, 29 upregulated and 28 downregulated genes were detected; whereas 54 genes were upregulated in the same cells treated with LDSGT. Moreover, the detected gene expression patterns were also confirmed by using the reverse transcription-polymerase chain reaction assay. Conclusion: This study initiates the evaluations of drug efficacies and gene expression profiles of traditional Chinese medicines, which may provide important information and identify useful biomarkers for treating cancers

Risk factors for neonatal early-onset group B streptococcus-related diseases after the implementation of a universal screening program in Taiwan

Abstract Background We examined the risk for Group B streptococcus (GBS)-related diseases in newborns born to mothers who participated in a universal GBS screening program and to determine whether differences are observed in factors affecting the morbidity for neonatal early-onset GBS-related diseases. Methods This is a retrospective study and the study subjects were women who had undergone GBS screening and who gave birth naturally and their newborns between April 15, 2012 and December 31, 2013. Data from the GBS screening system database and the National Health Insurance database were collected to calculate the GBS prevalence in pregnant women and morbidity of newborns with early-onset GBS-related diseases. Results The GBS prevalence in pregnant women who gave birth naturally was 19.58%. The rate of early-onset infection caused by GBS in newborns decreased from the original 0.1% to 0.02%, a decrease of as high as 80%. After the implementation of the universal GBS screening program, only three factors, including positive GBS screening result (OR = 2.84), CCI (OR = 2.45), and preterm birth (OR = 4.81) affected the morbidity for neonatal early-onset GBS-related diseases, whereas other factors had no significant impact. Conclusion The implementation of the universal GBS screening program decreased the infection rate of neonatal early-onset GBS diseases. The effects of socioeconomic factors and high-risk pregnancy on early-onset GBS infections were weakened

The Effectiveness of Case Management for Burn Patients in a Medical Center

[[abstract]]本研究旨在探討個案管理模式於燒燙傷病患照護之成效，包括病患知識、居家自我照護行為、對醫護人員服務之滿意度、平均住院天數、及平均住院醫療費用。 在北台灣某醫學中心進行一個為期16個月針對燒傷病患提供個案管理照護模式的類實驗性研究。以立意取樣的方式將病患分為對照組（n=30人）接收傳統的照護，實驗組（n=40）接受額外的個案管理照護，包括接受自我照護教育及符合治療指引的照護服務。 個案管理介入16個月後實施前後比較均達統計上顯著差異，病患知識在實驗組有明顯地增加由5.95分進步到9.63分，對照組的進步較些微由5.07分增加到7.20分。居家自我照護行為執行正確率實驗組比對照組有明顯地進步（85.50%比70.28%），對醫護人員滿意度亦有明顯高出（108.78分比86.83分）。平均住院天數實驗組比對照組有明顯縮短（16.23天比23.17天），平均住院醫療費用亦有明顯降低（138,467.58元比219,582.23元）。 經個案管理模式實施，提供燒燙傷病患較完整的照護方針，促進多專科團隊合作，建議推展至其他高成本高數量疾病之個案。 This study investigated how nursing case management impacts patient knowledge, self-care behavior at home, satisfaction with healthcare, average length of stay and costs. A sixteen-month quasi-experimental design was conducted in the burn unit of a Taipei medical center. A purposive sampling method was used to collect data. Burn patients were assigned to a control group (CG)(n=30) who received standard care from their primary care nurse or an intervention group (IG)(n=40) who received additional management, including education in self-management and implementation of burn guidelines for treating burn victims. After 16 months, patient knowledge scores significantly increased from 5.95 to 9.63 in IG as compared to a slight increase from 5.07 to 7.20 in CG. Primary outcome scores also improved significantly in IG: self-care behavior at home scores improved from 70.28% to 85.50%, and satisfaction with healthcare improved from 86.83% to 108.78%. Secondary outcomes improved significantly in IG compared to CG: average length of stay improved from 23.17 to 16.23 days, and cost improved from 219, 582.23 to 138,467.58 NT dollars. Results of this study have major implications for health care management models. First, more comprehensive guidelines for burn patient care can be structured. Still, the findings demonstrate great progress in cooperation between multidisciplinary team members in burn center. Finally, this case management model can be implemented in other high-cost and high-volume patients groups

Theoretical Study of the Protonation of the One-Electron-Reduced Guanine–Cytosine Base Pair by Water

Prototropic equilibria in ionized DNA play an important role in charge transport and radiation damage of DNA and, therefore, continue to attract considerable attention. Although it is well-established that electron attachment will induce an interbase proton transfer from N1 of guanine (G) to N3 of cytosine (C), the question of whether the surrounding water in the major and minor grooves can protonate the one-electron-reduced G:C base pair still remains open. In this work, density functional theory (DFT) calculations were employed to investigate the energetics and mechanism for the protonation of the one-electron-reduced G:C base pair by water. Through the calculations of thermochemical cycles, the protonation free energies were estimated to be in the range of 11.6–14.2 kcal/mol. The calculations for the models of C^•–(H₂O)₈ and G­(−H1)⁻(H₂O)₁₆, which were used to simulate the detailed processes of protonation by water before and after the interbase proton transfer, respectively, revealed that the protonation proceeds through a concerted double proton transfer involving the water molecules in the first and second hydration shells. Comparing the present results with the rates of interbase proton transfer and charge transfer along DNA suggests that protonation on the C^•– moiety is not competitive with interbase proton transfer, but the possibility of protonation on the G­(−H1)⁻ moiety after interbase proton transfer cannot be excluded. Electronic-excited-state calculations were also carried out by the time-dependent DFT approach. This information is valuable for experimental identification in the future

Oral Rg1 supplementation strengthens antioxidant defense system against exercise-induced oxidative stress in rat skeletal muscles

Abstract Background Previous studies reported divergent results on nutraceutical actions and free radical scavenging capability of ginseng extracts. Variations in ginsenoside profile of ginseng due to different soil and cultivating season may contribute to the inconsistency. To circumvent this drawback, we assessed the effect of major ginsenoside-Rg1 (Rg1) on skeletal muscle antioxidant defense system against exhaustive exercise-induced oxidative stress. Methods Forty weight-matched rats were evenly divided into control (N = 20) and Rg1 (N = 20) groups. Rg1 was orally administered at the dose of 0.1 mg/kg bodyweight per day for 10-week. After this long-term Rg1 administration, ten rats from each group performed an exhaustive swimming, and remaining rats considered as non-exercise control. Tibialis anterior (TA) muscles were surgically collected immediately after exercise along with non-exercise rats. Results Exhaustive exercise significantly (p Conclusions This study provide compelling evidences that Rg1 supplementation can strengthen antioxidant defense system in skeletal muscle and completely attenuate the membrane lipid peroxidation induced by exhaustive exercise. Our findings suggest that Rg1 can use as a nutraceutical supplement to buffer the exhaustive exercise-induced oxidative stress.</p