Association among serum uric acid, cardiovascular risk, and arterial stiffness: a cross-sectional study in She ethnic minority group of Fujian Province in China

OBJECTIVES

To investigate the association between serum uric acid levels, cardiovascular risk, and arterial stiffness in She ethnic minority in South China's Fujian Province.

METHODS

5109 participants aged 20-79 yr were enrolled in analysis. Tpeak-Tend interval (Tp-e), QT interval, and height of the R wave in lead aVL (aVLR) were measured on 12-lead electrocardiogram (ECG), and Minnesota code-indicated major abnormal ECG MA-ECG was used as a risk indicator of cardiovascular disease. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV).

RESULTS

Longer Tp-e interval, greater Tp-e/QT ratio, and higher aVLR were observed in the highest quartile of uric acid level. The incidence of MA-ECG was gradually increased from lowest to highest quartile of serum uric acid in males (p for trend <0.01). After adjusting traditional cardiovascular risk factors, multivariate analysis revealed that the fourth quartile of serum uric acid level was independently associated with MA-ECG in males [odds ratios (OR) (95% confidence interval): 2.129 (1.376-3.295)] but not in females. Serum uric acid was also associated with abnormal baPWV, when adjusted for atherogenic confounders. Compared with the lowest serum uric acid quartile, the OR (95% confidence interval) of the second, third, and fourth quartile were 1.920 (1.246-2.957), 1.650 (1.064-2.558), and 2.501 (1.600-3.908) in males.

CONCLUSION

Among China's She ethnic minority, uric acid level was independently related to arterial stiffness assessed by baPWV in both genders. The evaluation of uric acid level was related to higher cardiovascular risk in males but not in females.

Glycated hemoglobin, diabetes mellitus, and cardiovascular risk in a cross-sectional study among She Chinese population

OBJECTIVE

To determine whether glycated hemoglobin (HbA1c) could be used to diagnose Type 2 diabetes mellitus in She Chinese People and to assess the role of HbA1c in the development of cardiovascular disease.

RESEARCH DESIGN AND METHODS

An ethnically representative sample of 687 (277 males and 410 females) adults, 20 yr of age or older participated in the study, and 75-g oral glucose tolerance test was administrated. Based on receiver operating characteristic curves, various cut-off values of HbA1c were used to stratify glucose tolerance. Several indexes were used to assess the cardiovascular risk, including estimated glomerular filtration rate (eGFR), Tpeak-end, Tp-e dispersion, aVL R wave, and QTc.

RESULTS

Using World Health Organization as gold standard, the HbA1c value of 6.9% was optimal to diagnose diabetes mellitus with a sensitivity of 35.3% and specificity of 94.0%. And for impaired fasting glucose, impaired glucose tolerance, and impaired glucose regulation, the cut-off points were all 6.1%. Assessed by logistic regression model, HbA1c was an independent risk factor for the decline in eGFR; R wave in lead aVL increased significantly (p<0.05) with the increase of HbA1c values. Other indexes reflecting the cardiovascular risks were not meaningful in our study.

CONCLUSIONS

HbA1c may be not a preferred method to diagnose Type2 diabetes in She Chinese people. However, more attention should be paid to subjects with HbA1c>6.1%, and their blood glucose should be tightly measured in clinical practice. In addition, we suggest that HbA1c is a predictor of cardiovascular disease.

Report of 457 sporotrichosis cases from Jilin province, northeast China, a serious endemic region

BACKGROUND

Most reported sporotrichosis cases came from South American countries, the USA, India and Japan. This mycosis is also endemic in Northeast China. However, the situation is not clear for international researchers due to lack of large series reported in English.

OBJECTIVES

To report and analyse 457 sporotrichosis cases.

METHODS

Retrospective study of 457 cases of sporotrichosis diagnosed by fungal culture at the First Hospital of Jilin University from 1 January 2007 to 31 December 2009.

RESULTS

In this series, the male: female ratio was 1:1.42. Mean age was 41.2 years. Cases from age group 51-60 years accounted for most of the cases (22.54%). A total of 434 patients lived in rural areas (94.97%). The onset of symptoms in 67.61% cases happened in cold seasons (winter and spring). History of trauma presented in 133 cases (29.1%). The mean duration of the symptoms before the presentation was 6.41 months. A total of 190 (41.58%) showed lymphocutaneous form, 252 patients (55.14%) showed fixed form, 8 patients (1.75%) showed disseminated cutaneous sporotrichosis and the clinical form of 7 patients (1.53%) could not be defined. Extremities and nodules were the most frequently involved sites and founded manifestation. Main histopathology findings were suppurative granuloma, tuberculoid granuloma and mixed inflammatory granuloma. A total of 75 cases (19.74%) had fungal elements revealed by Periodic Acid-Schiff staining. Patients responded well to potassium iodide (KI), itraconazole, terbinafine and combinations of these agents with a mean course of 2.17 months to resolve.

CONCLUSION

As the first report of a large series of sporotrichosis cases from China to be published in English literature, our study indicated a serious sporotrichosis endemic situation in Jilin province, Northeast China, with epidemiological and clinical characteristics similar to those of previous Chinese reports, but different from those in other countries. KI, itraconazole and terbinafine are effective for the treatment.

High glucose-induced expression of inflammatory cytokines and reactive oxygen species in cultured astrocytes

Astrocyte activation plays important roles both in physiological and pathological process in the CNS. In the latter, the process is further aggravated by hyperglycemia, leading to diabetes complications of CNS. We report here that high glucose (HG) treatment stimulated astrocytic morphological alteration coupled with changes in glial fibrillary acidic protein (GFAP) and vimentin expression. Additionally, HG upregulated the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), interleukin-4 (IL-4), and vascular endothelial growth factor (VEGF); however, its effects on transforming growth factor-β (TGF-β) expression were not evident. HG treatment induced increased production of reactive oxygen species (ROS) as well as activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and signal transducer and activator transcription 3 (STAT 3). HG-induced expression of TNF-α, IL-6, IL-1β, IL-4, and VEGF was blocked by ROS scavenger and inhibitors specific for NF-κB and STAT 3, respectively. The results suggest that the aforementioned multiple inflammatory cytokines and mediators that may be linked to the pathogenesis of the diabetes complications of CNS are induced by HG via the key signaling pathways.

A biomaterials approach to peripheral nerve regeneration: bridging the peripheral nerve gap and enhancing functional recovery

Microsurgical techniques for the treatment of large peripheral nerve injuries (such as the gold standard autograft) and its main clinically approved alternative--hollow nerve guidance conduits (NGCs)--have a number of limitations that need to be addressed. NGCs, in particular, are limited to treating a relatively short nerve gap (4 cm in length) and are often associated with poor functional recovery. Recent advances in biomaterials and tissue engineering approaches are seeking to overcome the limitations associated with these treatment methods. This review critically discusses the advances in biomaterial-based NGCs, their limitations and where future improvements may be required. Recent developments include the incorporation of topographical guidance features and/or intraluminal structures, which attempt to guide Schwann cell (SC) migration and axonal regrowth towards their distal targets. The use of such strategies requires consideration of the size and distribution of these topographical features, as well as a suitable surface for cell-material interactions. Likewise, cellular and molecular-based therapies are being considered for the creation of a more conductive nerve microenvironment. For example, hurdles associated with the short half-lives and low stability of molecular therapies are being surmounted through the use of controlled delivery systems. Similarly, cells (SCs, stem cells and genetically modified cells) are being delivered with biomaterial matrices in attempts to control their dispersion and to facilitate their incorporation within the host regeneration process. Despite recent advances in peripheral nerve repair, there are a number of key factors that need to be considered in order for these new technologies to reach the clinic.

Non-immortalized human tenocyte cultures as a vehicle for understanding cellular aspects to tendinopathy

The biochemical mechanisms underlying tendinopathy are obscure. We briefly describe preliminary observations of human tenocyte behaviour in culture as a vehicle for determining the role of reactive oxygen in tendon pathology.

Identification of the IFITM3 gene as an inhibitor of hepatitis C viral translation in a stable STAT1 cell line

To investigate the functions of signal transducers and activators of transcription 1 (STAT1)-induced anti-hepatitis C viral (HCV) effects, a stable Huh7.5 cell line (Huh7.5-STAT1ER) was established that constitutively expresses a fusion protein (STAT1ER) of STAT1 and the mouse oestrogen receptor (ER), which forms STAT1ER homodimers after 4-hydroxytamoxifen (4-HT) treatment. This inducible and cytokine/receptor-independent STAT1 activation system allowed us to investigate the anti-HCV effects of STAT1ER activation after inducing IFN-stimulated gene (ISG) expression. The anti-HCV effects of dimerized STAT1ER fusion protein were determined by real-time PCR in a time-dependent fashion post-HCV (JFH-1) infection. HCV (JFH-1) RNA decreased 48% at 72 h after 4-HT treatment. To distinguish the inhibitory effects of STAT1ER activation on HCV RNA replication or HCV internal ribosomal entry site (IRES)-mediated translation, a dicistronic pRL-HL construct was used in the studies. Both cellular (Cap-dependent) and HCV IRES-mediated (Cap-independent) translation were decreased by 63% and 57% at 72 h post-STAT1ER activation in the STAT1ER cell line. In our previous studies, interferon-induced transmembrane protein 3 [(IFITM3) (1-8U)] was found to inhibit HCV RNA replication. Subsequently, elevated expression of the 1-8U gene was confirmed by Western blotting in the Huh7.5-STAT1ER cell line. To further investigate the 1-8U function with both in vivo and in vitro studies, the 1-8U gene was found to suppress cellular and HCV IRES-mediated translation.

BioMart Central Portal: an open database network for the biological community

BioMart Central Portal is a first of its kind, community-driven effort to provide unified access to dozens of biological databases spanning genomics, proteomics, model organisms, cancer data, ontology information and more. Anybody can contribute an independently maintained resource to the Central Portal, allowing it to be exposed to and shared with the research community, and linking it with the other resources in the portal. Users can take advantage of the common interface to quickly utilize different sources without learning a new system for each. The system also simplifies cross-database searches that might otherwise require several complicated steps. Several integrated tools streamline common tasks, such as converting between ID formats and retrieving sequences. The combination of a wide variety of databases, an easy-to-use interface, robust programmatic access and the array of tools make Central Portal a one-stop shop for biological data querying. Here, we describe the structure of Central Portal and show example queries to demonstrate its capabilities.

Be alert to tuberculosis-mediated glomerulonephritis: a retrospective study

Mycobacterium tuberculosis infection causing glomerulonephritis is a rare disorder. This retrospective study analyzed the clinical characteristics of patients diagnosed with tuberculosis-mediated glomerulonephritis (TB-GN) between 2002 and 2009, as well as the diagnostic tools used. These findings were then compared with those of patients with primary glomerulonephritis (P-GN). The records of all patients were reviewed. The diagnosis of TB-GN was based on renal hematuria and/or proteinuria and cure after antituberculosis therapy alone plus urine culture positive for M. tuberculosis, demonstration of typical tubercle granulomas on renal biopsy specimens, or the detection of M. tuberculosis DNA by polymerase chain reaction (PCR) on renal specimens. Forty-six patients with TB-GN and 49 patients with P-GN were included. Compared with patients in the P-GN group, most (76%) patients with TB-GN had a history of TB. Systemic symptoms were much more frequent in patients with TB-GN than local genitourinary symptoms. Serological testing showed a statistical difference between the two groups. Immunoglobulin A nephropathy was found in the majority (72%) of patients with TB-GN. M. tuberculosis DNA detection was positive in 39 (84.8%) patients, a much higher positive rate of diagnosis than that with urine culture for M. tuberculosis. The manifestation of TB-GN is atypical and nonspecific. It warrants a high index of suspicion when patients with renal hematuria and proteinuria fail to respond to standard treatments for P-GN. Clinicians should pay close attention to the medical history and results of special laboratory tests. M. tuberculosis DNA detection on renal biopsy specimens should be considered in order to confirm the diagnosis of TB-GN.

Serum γ-glutamyltransferase and associated damage among a She Chinese population

OBJECTIVE

It has been suggested that serum γ-glutamyltransferase is independently associated with cardiovascular mortality and atherosclerosis. The present study is to investigate the relationship between serum γ-glutamyltransferase and potential associated damage in an adult She Chinese population.

METHOD

A multistage, stratified, cluster, random sampling method was used to select an ethnically representative group of individuals aged 20-80 years in the general population. Brachial-ankle pulse-wave velocity was used to assess arterial stiffness in the general population and the Toronto Clinical Neuropathy Scoring System was used to detect diabetic peripheral polyneuropathy among populations with diabetes.

RESULTS

A total of 5385 subjects were entered into the analysis. Serum γ-glutamyltransferase levels were classified into four groups using the 25th, 50th and 75th percentiles as cut points (males: < 20, 20-29, 29-52 and > 52 U/l; females: < 13, 13-18, 18-25 and > 25 U/l). As compared with the first quartile, the relative risks of arterial stiffness were 1.418, 1.667 and 2.394 in the other three categories, respectively (test for trend P < 0.05). After adjustment in five models, serum γ-glutamyltransferase was still a risk factor of arterial stiffness. We found inverted U-shape curves in both genders and the third quartile (male: 29 52 U/l; female: 18-25 U/l) had the highest odds ratios of 1.640 and 1.529, respectively.

CONCLUSIONS

We demonstrated that high serum γ-glutamyltransferase concentrations were directly associated with the increased risk of arterial stiffness, in general, and with peripheral polyneuropathy in subjects with diabetes in an ethnic She Chinese population. Alcohol use, gender, BMI and blood pressure were related to serum γ-glutamyltransferase and were involved in the relationship between serum γ-glutamyltransferase and brachial-ankle pulse-wave velocity.

Remote pharmacological post-conditioning by intrathecal morphine: cardiac protection from spinal opioid receptor activation

BACKGROUND

Intrathecal morphine pre-conditioning attenuates cardiac ischemia-reperfusion injury via activation of central opioid receptors. We hypothesized that intrathecal morphine also post-conditions the myocardium in the rat.

METHODS

Intrathecal morphine at 0.3 μg/kg (LMPC), 3 μg/kg (MMPC) or 30 μg/kg (HMPC) was administered for 5 min before 120-min reperfusion following 30-min ischemia. Infarct size as a percentage of area at risk (IS/AAR) was determined using triphenyltetrazolium staining. MMPC was repeated following the intrathecal administration of nor BNI, NTD, CTOP, or naloxone methiodide (NM), kappa, delta, mu and non-specific opioid receptor antagonists, respectively. The role of peripheral opioid, adenosine and calcitonin gene-related peptide (CGRP) receptors was examined by the intravenous administration of NM, 8-ρ-sulfophenyl theophylline (8-SPT) and human CGRP fragment (CGRP(8-37)), respectively.

RESULTS

Morphine post-conditioning at all three doses was cardioprotective (IS/AAR of LMPC=37 ± 4%, MMPC=35 ± 5%, HMPC=32 ± 4%, control=50 ± 5%, P<0.01). The prior administration of opioid receptor antagonists intrathecally, as well as intravenous 8-SPT and CGRP(8-37) receptor antagonists, abolished this effect (nor BNI+MMPC=47 ± 7%, NTD+MMPC=49 ± 7%, CTOP+MMPC=45 ± 9%, NM+MMPC=47 ± 6% 8-SPT+MPC=46 ± 5% & CGRP(8-37)+MPC=53 ± 6%, P=0.63). However, the intravenous administration of NM did not prevent the protective effect (34 ± 4%, P<0.01).

CONCLUSIONS

Intrathecal morphine administration can induce pharmacological cardiac post-conditioning as it involves opioid receptor centrally but non-opioid receptors peripherally.

Porphyromonas gingivalis infection sequesters pro-apoptotic Bad through Akt in primary gingival epithelial cells

Porphyromonas gingivalis, a self-limiting oral pathogen, can colonize and replicate in gingival epithelial cells (GECs). P. gingivalis-infected GECs are protected from mitochondrion-dependent apoptosis, partially through activation of phosphatidyl inositol 3-kinase/Akt signaling. Biochemical events associated with P. gingivalis-induced inhibition of apoptosis include the blocking of mitochondrial membrane permeability and cytochrome-c release. We studied functional importance of Akt and the status of associated key mitochondrial molecules, pro-apoptotic Bad and caspase-9, during infection of GECs. We found that P. gingivalis infection caused significant phosphorylation of Bad progressively, while messenger RNA levels for Bad slowly decreased. Fluorescence microscopy showed translocation of the mitochondrial Bad to the cytosol post-infection. Conversely, P. gingivalis lost the ability to promote phosphorylation and translocation of Bad in Akt-deficient GECs. Caspase-9 activation induced by a chemical inducer of apoptosis was significantly inhibited by infection over time. However, Akt depletion by small interfering RNA did not reverse inhibition of caspase-9 activation by infection. Hence, P. gingivalis inactivates pro-apoptotic Bad through Akt. The inhibition of caspase-9 activation appears to be independent of Akt. Overall, our findings suggest that Akt is a key component of anti-apoptotic pathways stimulated by P. gingivalis. The P. gingivalis uses other mitochondrial pathways to protect host cells from cell-death and to ensure its survival in gingival epithelium.

Clonal Status and Clinicopathological Features of Langerhans Cell Histiocytosis

Some studies have demonstrated that Langerhans cell histiocytosis (LCH) is a neoplastic hyperplasia of Langerhans cells, however some researchers consider that clonality should be assessed in more patients with LCH, both at disease presentation and during the disease course. Monoclonality is a major characteristic of most tumours, whereas normal tissue and reactive hyperplasia are polyclonal. To elucidate the nature of Langerhans cells further, the present study investigated the clinicopathological features and clonality of three cases of LCH in female patients using laser microdissection and a clonality assay, based on X-chromosomal inactivation mosaicism in somatic tissues and polymorphism of the androgen receptor gene. The results indicated that LCH was composed of Langerhans cells with a characteristic morphological appearance, eosinophils, giant cells, neutrophils and foamy cells. Immunohistochemically, the Langerhans cells were positive for CD1a, S-100 protein and vimentin. The clonality assay demonstrated that the Langerhans cells formed a monoclonal population, showing that LCH is neoplastic. We conclude that LCH is characterized by clonal proliferation, although additional studies with larger sample sizes are required to prove this conclusively.