Efficacy of Probiotics Supplementation On Chronic Kidney Disease: a Systematic Review and Meta-Analysis

Background/Aims: Dysbiosis of the intestinal microbiota may accelerate the progression of chronic kidney disease (CKD) by increasing the levels of urea toxins. In recent years, probiotics have been recognized to maintain the physiological balance of the intestinal microbiota. In this study, we aim to assess the therapeutic effects of probiotics on CKD patients with and without dialysis via meta-analysis. Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) by searching the databases of Pubmed, EMBASE and Cochrane Library (No. CRD42018093080). Studies on probiotics for treatment of CKD adults lasting for at least 4 weeks were selected. The primary outcomes were the levels of urea toxins, and the second outcomes were the levels of interleukin (IL)-6, C-reactive protein (CRP) and hemoglobin (Hb). The risk of bias was assessed by Cochrane Collaboration’ tool, and the quality of evidence was appraised with the Grading of Recommendation Assessment. Means and standard deviations were analyzed by random effects analysis. Stratified analysis was done and sensitivity analysis was performed when appropriate. Results: Totally, eight studies with 261 patients at CKD stage 3 to 5 with and without dialysis were included. We found a decrease of p-cresyl sulfate (PCS) of 3 studies with 125 subjects (P = 0.01, SMD -0.57, 95% CI, -0.99 to -0.14, I2 = 25%) and an increase of IL-6 in 3 studies with 134 subjects (P = 0.03, 95% CI, SMD 0.37, 0.03 to 0.72, I2 = 0%) in the probiotics groups. Analysis of serum creatinine (P = 0.47), blood urine nitrogen (P = 0.73), CRP (P = 0.55) and Hb (P = 0.49) yielded insignificant difference. Conclusion: Limited number of studies and small sample size are limitations of our study. Probiotics supplementation may reduce the levels of PCS and elevate the levels of IL-6 whereby protecting the intestinal epithelial barrier of patients with CKD

Ultrafast laser inscribed cladding waveguides in Nd:YAG crystal for mid-infrared wavelength

We report on tubular cladding optical waveguides fabricated in neodymium doped yttrium aluminum garnet (Nd:YAG) crystal by ultrafast laser inscription. The structure can support guidance at the wavelength of 4 μm for the TE and TM polarizations. The refractive index contrasts of the cladding waveguides for the two transverse polarizations were estimated to be ΔnTE≈−7.5×10−3 and ΔnTM≈−6.5×10−3. The propagation losses of the cladding waveguides at the wavelength of 4 μm were determined to be as low as ~0.7 dB/cm for the TE polarization and ~1.0 dB/cm for the TM polarization.The work is supported by the National Natural Science Foundation of China (Nos. 11274203 and 11111130200), the Spanish Ministerio de Ciencia e Innovación (CSD2007-00013 and FIS2009-09522) and the Junta de Castilla y León (Project SA086A12-2)

Femtosecond laser direct writing of few-mode depressed-cladding waveguide lasers

We report on mirrorless laser operation of Nd:YVO4 single- and double-cladding waveguides fabricated by femtosecond laser direct writing. Fundamental- (LP01) and high-order-mode (LP03, LP05) guiding and lasing have been observed in waveguides with different geometries and sizes. Double-cladding waveguides exhibit good guiding and lasing performance via inheriting advantages respectively from individual single cladding. As a result, continuous-wave lasing with a threshold as low as 59 mW is obtained, depending on the optical feedback provided only by Fresnel reflections at the waveguide end faces. By using few-layer graphene as saturable absorber, passively Q-switched operation in fabricated waveguides is also achieved.National Natural Science Foundation of China (11704201, 61775120); Consejería de Educación, Junta de Castilla y León (SA287P18); Ministerio de Economía y Competitividad (FIS2017-87970R); Natural Science Foundation of Tianjin City (17JCQNJC01600)

Postawy szlachty polskiej z terenów II zaboru pruskiego wobec władz pruskich z 1793 r.

Wczesną wiosną 1793 r. praktycznie bez walki Prusy przejęły większość ziem przypadłych im w wyniku II rozbioru1. Konfederacja targowicka nie zdobyła się na ostrzejsze wystąpienie w ich obronie1 2. Dywizja Arnolda Byszewskiego, stacjonująca w Wielkopolsce, mimo iż miała realne szanse przeciwstawić się armii pruskiej, nie otrzymała takiego rozkazu od konfederacji generalnej3[…

Puerarin attenuates pressure overload-induced cardiac hypertrophy

AbstractBackgroundPuerarin is the most abundant isoflavonoid in kudzu root. It has been used to treat angina pectoris and myocardial infarction clinically. However, little is known about the effect of puerarin on cardiac hypertrophy.MethodsAortic banding (AB) was performed to induce cardiac hypertrophy in mice. Puerarin premixed in diets was administered to mice after one week of AB. Echocardiography and catheter-based measurements of hemodynamic parameters were performed at 7 weeks after starting puerarin treatment (8 weeks post-surgery). The extent of cardiac hypertrophy was also evaluated by pathological and molecular analyses of heart samples. Cardiomyocyte apoptosis was assessed by measuring Bax and Bcl-2 protein expression and terminal deoxynucleotidyl transferase dUTP nick end labeling staining. In addition, the inhibitory effect of puerarin (1μM, 5μM, 10μM, 20μM, 40μM) on mRNA expression of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in Ang II (1μM)-stimulated H9c2 cells was investigated using quantitative real-time reverse transcription-polymerase chain reaction.ResultsEchocardiography and catheter-based measurements of hemodynamic parameters at 7 weeks revealed the amelioration of systolic and diastolic abnormalities. Puerarin also decreased cardiac fibrosis in AB mice. Moreover, the beneficial effect of puerarin was associated with the normalization in gene expression of hypertrophic and fibrotic markers. Further studies showed that pressure overload significantly induced the activation of phosphoinositide 3-kinase (PI3K)/Akt signaling and c-Jun N-terminal kinase (JNK) signaling, which was blocked by puerarin treatment. Cardiomyocyte apoptosis and induction of Bax in response to AB were suppressed by puerarin. Furthermore, the increased mRNA expression of ANP and BNP induced by Ang II (1μM) was restrained to a different extent by different concentrations of puerarin.ConclusionPuerarin may have an ability to retard the progression of cardiac hypertrophy and apoptosis which is probably mediated by the blockade of PI3K/Akt and JNK signaling pathways

The efficacy and safety of quantitative flow ratio-guided complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease: A pilot randomized controlled trial

Background: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD), the treatment strategy for non-infarct-related artery (non-IRA) remains controversial. Quantitative flow ratio (QFR) is a new angiography-based physiological assessment index. However, there is little evidence on the practical clinical application of QFR. Methods: Two hundred and twenty-nine patients with STEMI and MVD were recruited for this study. Patients were randomly assigned to either receive QFR-guided complete revascularization (QFR-G-CR) of non-IRA or receive no further invasive treatment. The primary (1º) endpoint analyzed included death due to all causes, non-fatal myocardial infarction (MI), and ischemia-induced revascularization at 12 months post-surgery. Secondary (2º) endpoints included cardiovascular death, unstable angina, stent thrombosis, New York Heart Association (NYHA) class IV heart failure (HF), and stroke at 1 year post surgery. Massive bleeding and contrast-associated acute kidney injury (CAKI) were used as safety endpoints. Results: Around the 12 month follow up, the 1º outcome was recorded in 11/115 patients (9.6%) in the QFR-G-CR population, relative to 23/114 patients (20.1%) in the IRA-only PCI population (hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.22–0.92; p = 0.025). Unstable angina in 6 (5.2%) and 16 (14.0%) patients (HR: 0.36; 95% CI: 0.14–0.92; p = 0.026), respectively. No marked alterations were found in the massive bleeding and CAKI categories. Conclusions: In conclusion, STEMI and MVD patients can benefit from QFR-G-CR of non-IRA lesions in the initial stages of acute MI. This can help reduce incidences of major adverse cardiovascular events and unstable angina, relative to IRA treatment only. Chinese Clinical Trial Registration number: ChiCTR2100044120