Two-step shoulder delivery method reduces the incidence of shoulder dystocia

OBJECTIVE

io compare two-step method ot shoulder delivery with one-step for the maternal and neonatal outcomes.

MATERIALS AND METHODS

This was a randomized controlled clinical trial. Women scheduled for vaginal delivery without severe complications were enrolled and randomly arranged into two groups. Women in study group were delivered by two-step method for shoulder delivery, that is to wait for at least one contraction after head delivery, and naturally delivery of shoulder. Women in controlled group were delivered by one-step method, that is after the head was delivered, gentle press of head was applied to facility shoulder delivery. Maternal and neonatal outcomes as Apgar score, rate of shoulder dystocia, and postpartum bleeding were recorded. Interval of head to shoulder was timed in second.

RESULTS

The study group had lower rate of shoulder dystocia than that in control group (X²= 4.27,p =0.03), no increasing of asphyxia, and postpartum bleeding. The average interval of head to shoulder in study group was longer than that in control group. There was no difference in interval between shoulder dystocia vs. normal birth group, neither was there a difference in interval between asphyxia babies and normal babies group. By two-step method, the mean value of head to shoulder interval was 59.025 seconds, 95% CI (20.000-150.000 seconds), mean+2xSD = 148.927 seconds. In one-step group, mean was 44.172 seconds, 95% CI= (10.000~105.000 seconds), mean +2xSD = 94.812 seconds.

CONCLUSION

Two-step method of shoulder delivery had a lower rate of shoulder dystocia than one-step method, no increasing of neonatal asphyxia and postpartum bleeding. The longer interval of head to shoulder did not relate to shoulder dystocia and asphyxia. The normal value of head to shoulder interval might be longer than 60 seconds.

Mps1 kinase regulates tumor cell viability via its novel role in mitochondria

Targeting mitotic kinase monopolar spindle 1 (Mps1) for tumor therapy has been investigated for many years. Although it was suggested that Mps1 regulates cell viability through its role in spindle assembly checkpoint (SAC), the underlying mechanism remains less defined. In an endeavor to reveal the role of high levels of mitotic kinase Mps1 in the development of colon cancer, we unexpectedly found the amount of Mps1 required for cell survival far exceeds that of maintaining SAC in aneuploid cell lines. This suggests that other functions of Mps1 besides SAC are also employed to maintain cell viability. Mps1 regulates cell viability independent of its role in cytokinesis as the genetic depletion of Mps1 spanning from metaphase to cytokinesis affects neither cytokinesis nor cell viability. Furthermore, we developed a single-cycle inhibition strategy that allows disruption of Mps1 function only in mitosis. Using this strategy, we found the functions of Mps1 in mitosis are vital for cell viability as short-term treatment of mitotic colon cancer cell lines with Mps1 inhibitors is sufficient to cause cell death. Interestingly, Mps1 inhibitors synergize with microtubule depolymerizing drug in promoting polyploidization but not in tumor cell growth inhibition. Finally, we found that Mps1 can be recruited to mitochondria by binding to voltage-dependent anion channel 1 (VDAC1) via its C-terminal fragment. This interaction is essential for cell viability as Mps1 mutant defective for interaction fails to main cell viability, causing the release of cytochrome c. Meanwhile, deprivation of VDAC1 can make tumor cells refractory to loss of Mps1-induced cell death. Collectively, we conclude that inhibition of the novel mitochondrial function Mps1 is sufficient to kill tumor cells.

Cross-cultural validation of the 20-item Toronto Alexithymia Scale in Chinese adolescents

WHAT IS KNOWN ON THE SUBJECT?: The TAS-20 is the most widely used self-reported questionnaire to assess the level of alexithymia in students and community and clinical samples. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The TAS-20-C exhibited high levels of reliability and validity, indicating that it is appropriate for the assessment of alexithymia in Chinese adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Screening adolescents who are at risk of alexithymia through the TAS-20 could help to perform necessary and effective precautions to decrease the adverse effects of alexithymia, such as the risks of developing depressive mood and behavioral problems.

ABSTRACT

Purpose The aim of this study was to examine the psychometric properties of the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) in a sample of Chinese adolescents. Method Adolescents (n = 1260) recruited from three schools in mainland China completed the TAS-20-C, the somatization subscale of the Symptom Checklist 90 (SCL-90) and Center for Epidemiological Studies Depression Scale (CES-D). Five different factorial models of the TAS-20 were tested using confirmatory factor analysis (CFA). Cronbach's α, mean inter-item correlations and predictive validity were also evaluated. Results Among those five different factorial models, the four-factor structure model was suitable and invariant across gender and age in this sample. The TAS-20-C demonstrated adequate internal reliability. Gender and age accounted for insignificant amounts of variability in total TAS-20-C and factor scores. TAS-20-C total and subscale scores were correlated significantly with SCL-90 somatization subscale and CES-D. Girls scored higher than boys on difficulty identifying feelings (DIF) and pragmatic thinking (PR) subscales. DIF and lack of subjective significance or importance of emotions (IMs) subscale scores were higher among younger than among middle and older adolescents. Implications for Practice Validating the TAS-20 in adolescents is quite important to use it in evaluating adolescents' alexithymia, and screen those at risk of alexithymia.

I148M variant of PNPLA3 increases the susceptibility to non-alcoholic fatty liver disease caused by obesity and metabolic disorders

BACKGROUND

The patatin-like phospholipase 3 (PNPLA3) rs738409 gene polymorphism is an important genetic determinant of non-alcoholic fatty liver disease (NAFLD). However, the associations between liver fat and metabolic traits in rs738409 G allele carriers and the allelic influence on this association have not been fully studied.

AIM

To investigate the influence of the PNPLA3 gene polymorphism on the association of liver fat with serum metabolic factors and carotid atherosclerosis.

METHODS

Liver fat was measured by quantitative ultrasound in 4300 subjects in the Shanghai Changfeng community and analysed for its association with obesity and metabolic factors in individuals with the PNPLA3 CC, CG and GG genotypes.

RESULTS

Non-alcoholic fatty liver disease occurred in 37.9% and 28.8% of the subjects with the GG and CC genotypes respectively (P < 0.001). Liver fat was significantly associated with body mass index, waist circumference, serum triglycerides, high-density lipoprotein cholesterol, fasting blood glucose and insulin in the PNPLA3 rs738409 G allele carriers (P < 0.001). Compared with the CC homozygotes, the GG homozygotes presented higher liver fat and liver fibrosis scores despite their better metabolic status (comparison of regression line slopes, P < 0.05). An increase in liver fat was accompanied by a significant increase in the average and maximum carotid intima-media thickness in subjects with the PNPLA3 CC genotype but not in those with the GG genotype.

CONCLUSIONS

PNPLA3 rs738409 G allele carriers were found to be more susceptible to the metabolic-related hepatic steatosis, and developed NAFLD and liver fibrosis despite presenting relatively better metabolic statuses and lower risks for carotid atherosclerosis.

A common polymorphism rs1800247 in osteocalcin gene was associated with serum osteocalcin levels, bone mineral density, and fracture: the Shanghai Changfeng Study

We evaluated the relationship between a common polymorphism rs1800247 in osteocalcin gene and serum osteocalcin levels, bone mineral density and fracture in Chinese. This was a population-based cross-sectional study. We demonstrated that rs1800247 was associated with bone mineral density and fracture in men and serum osteocalcin levels in women.

INTRODUCTION

This study aimed to evaluate the relationship between a common polymorphism rs1800247 in osteocalcin gene and serum total osteocalcin levels, bone mineral density (BMD) and fracture in Chinese middle-aged and elderly men and women.

METHODS

This was a population-based cross-sectional study included 5561 individuals aged 45 years or older. Information on fractures sustained after age of 45 were collected. BMD at the lumbar spine, femoral neck and total hip were measured using dual-energy X-ray absorptiometry. The genotyping of rs1800247 was performed by matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy.

RESULTS

rs1800247 was associated with lumbar spine BMD and femoral neck BMD in the dominant model adjusted for age, body mass index (BMI), serum total osteocalcin in men (both P = 0.04). Besides, rs1800247 was associated with fracture adjusted for age, BMI, serum total osteocalcin and total hip BMD in the additive and dominant models in men (P = 0.04 and 0.01). In the dominant model, the carriers of CC and TC genotypes was associated with a lower odds of fracture compared with the carriers of TT genotype (OR = 0.60, 95%CI 0.40-0.88, P = 0.01). In men, rs1800247 was not associated with serum total osteocalcin levels in additive, dominant or recessive models. However, rs1800247 was associated with serum total osteocalcin levels in all models adjusted for age, BMI, menopausal status and total hip BMD in women (all p < 0.001), with osteocalcin levels decreasing across TT, TC and CC genotypes. rs1800247 was not associated with BMD or fracture in all models in women.

CONCLUSIONS

A common polymorphism rs1800247 in osteocalcin gene may affect the risk of osteoporosis and fracture and serum total osteocalcin levels in Chinese, and there may be gender differences underlying these associations.

Assessment of genetic diversity of bermudagrass germplasm from southwest China and Africa by using AFLP markers

Cynodon dactylon (L.) Pers. var. dactylon (common bermudagrass) is widely distributed geographically between approximately 45°N and 45°S latitude, penetrating to approximately 53°N latitude in Europe. The extensive variation of morphological and adaptive characteristics of the taxon has been substantially documented, but information is lacking on DNA molecular variation in geographically disparate forms. The genetic diversity of 51 wild accessions of bermudagrass from southwest China (Sichuan, Chongqing, Yunnan, Guizhou, and Tibet) and 8 African bermudagrass was analyzed using amplified fragment length polymorphism molecular markers. A total of 670 polymorphic bands were detected with 11 primer combinations, of which 663 (98.74%) bands were found to be polymorphic. The genetic similarity among the accessions ranged from 0.64-0.96 with an average of 0.78. All 59 wild accessions were clustered into 5 eco-geographic groups, and nearly all accessions from the same area were classified into the same group and were found to be associated with their geographical distributions. Therefore, complex geographical and ecological environments are important factors for the genetic structure and geographical distribution of C. dactylon.

A genetic variant in SLC6A20 is associated with Type 2 diabetes in white-European and Chinese populations

AIMS

To investigate whether polymorphisms in SLC6A20 are associated with susceptibility to Type 2 diabetes.

METHODS

In the Rotterdam Study, a prospective, population-based cohort (n = 5974), 22 tagging polymorphisms with minor allele frequencies>0.05 across SLC6A20 were studied. Replication studies were performed in an independent Dutch case-control study (DiaGene-Rotterdam Study 2 n = 3133), and in a Chinese Han case-control population (n = 2279). A meta-analysis of the results was performed.

RESULTS

In the Rotterdam study, the minor alleles of rs13062383, rs10461016 and rs2286489 increased the risk of Type 2 diabetes (hazard ratio 1.37, 95% CI 1.15-1.63, hazard ratio 1.30 95% CI 1.09-1.54 and hazard ratio 1.20, 95% CI 1.07-1.35, respectively). In the DiaGene/Rotterdam Study 2, the A allele of rs13062383 increased the risk of Type 2 diabetes (odds ratio 1.45, 95% CI 1.19-1.76). In the Chinese Han study, the rs13062383 A allele also increased the risk of Type 2 diabetes (odds ratio 1.21, 95% CI 1.03-1.42). Meta-analysis showed a highly significant association of rs13062383 with Type 2 diabetes (odds ratio 1.35, 95% CI 1.21-1.47; P = 3.3 × 10⁻⁸).

CONCLUSIONS

In conclusion, rs13062383 in SLC6A20 increased the susceptibility to Type 2 diabetes in populations with different genetic backgrounds.

Ventilation Distribution Heterogeneity at Rest as a Marker of Exercise Impairment in Mild-to-Advanced COPD

The difference between total lung capacity (TLC) by body plethysmography and alveolar volume (VA) from the single-breath lung diffusing capacity measurement provides an index of ventilation distribution inequalities in COPD. The relevance of these abnormalities to dyspnea and exercise intolerance across the continuum of disease severity remains unknown. Two-hundred and seventy-six COPD patients distributed across GOLD grades 1 to 4 and 67 healthy controls were evaluated. The "poorly communicating fraction" (PCF) of the TLC was estimated as the ratio (%) of TLC to VA. Healthy subjects showed significantly lower PCF values compared to GOLD grades 1 to 4 (10 ± 3% vs. 17 ± 8% vs. 27 ± 10% vs. 37 ± 10% vs. 56 ± 11%, respectively; p < 0.05). Pulmonary gas exchange impairment, mechanical ventilatory constraints and ventilation-corrected dyspnea scores worsened across PCF tertiles (p < 0.05). Of note, GOLD grades 1 and 2 patients with the highest PCF values had pronounced exercise ventilatory inefficiency and dyspnea as a limiting symptom. In fact, dyspnea was a significant contributor to exercise limitation only in those with "moderate" or "extensive" PCF (p < 0.05). A receiver operating characteristics curve analysis revealed that PCF was a better predictor of severely reduced maximal exercise capacity than traditional pulmonary function indexes including FEV1 (area under the curve (95% confidence interval) = 0.85 (0.81-0.89), best cutoff = 33.4%; p < 0.01). In conclusion, PCF is a readily available functional marker of gas exchange and mechanical abnormalities relevant to dyspnea and exercise intolerance across the COPD grades.

Real-time experimental demonstrations of software reconfigurable optical OFDM transceivers utilizing DSP-based digital orthogonal filters for SDN PONs

Real-time optical OFDM (OOFDM) transceivers with on-line software-controllable channel reconfigurability and transmission performance adaptability are experimentally demonstrated, for the first time, utilizing Hilbert-pair-based 32-tap digital orthogonal filters implemented in FPGAs. By making use of an 8-bit DAC/ADC operating at 2GS/s, an oversampling factor of 2 and an EML intensity modulator, the demonstrated RF conversion-free transceiver supports end-to-end real-time simultaneous adaptive transmissions, within a 1GHz signal spectrum region, of a 2.03Gb/s in-phase OOFDM channel and a 1.41Gb/s quadrature-phase OOFDM channel over a 25km SSMF IMDD system. In addition, detailed experimental explorations are also undertaken of key physical mechanisms limiting the maximum achievable transmission performance, impacts of transceiver's channel multiplexing/demultiplexing operations on the system BER performance, and the feasibility of utilizing adaptive modulation to combat impairments associated with low-complexity digital filter designs. Furthermore, experimental results indicate that the transceiver incorporating a fixed digital orthogonal filter DSP architecture can be made transparent to various signal modulation formats up to 64-QAM.

Specific appetite, energetic and metabolomics responses to fat overfeeding in resistant-to-bodyweight-gain constitutional thinness

Background:

Contrasting with obesity, constitutional thinness (CT) is a rare condition of natural low bodyweight. CT exhibits preserved menstruation in females, no biological marker of undernutrition, no eating disorders but a bodyweight gain desire. Anorexigenic hormonal profile with high peptide tyrosine tyrosine (PYY) was shown in circadian profile. CT could be considered as the opposite of obesity, where some patients appear to resist diet-induced bodyweight loss.

Objective:

The objective of this study was to evaluate appetite regulatory hormones in CTs in an inverse paradigm of diet-induced weight loss.

Methods:

A 4-week fat overfeeding (2640 kJ excess) was performed to compare eight CT women (body mass index (BMI)<17.5 kg m⁻²) to eight female controls (BMI 18.5–25 kg m⁻²). Appetite regulatory hormones profile after test meal, food intake, bodyweight, body composition, energy expenditure and urine metabolomics profiles were monitored before and after overfeeding.

Results:

After overfeeding, fasting total and acylated ghrelin were significantly lower in CTs than in controls (P=0.01 and 0.03, respectively). After overfeeding, peptide tyrosine tyrosine (PYY) and glucagon-like-peptide 1 both presented earlier (T15 min vs T30 min) and higher post-meal responses (incremental area under the curve) in CTs compared with controls. CTs failed to increase bodyweight (+0.22±0.18 kg, P=0.26 vs baseline), contrasting with controls (+0.72±0.26 kg, P=0.03 vs baseline, P=0.01 vs CTs). Resting energy expenditure increased in CTs only (P=0.031 vs baseline). After overfeeding, a significant negative difference between total energy expenditure and food intake was noticed in CTs only (−2754±720 kJ, P=0.01).

Conclusion:

CTs showed specific adaptation to fat overfeeding: overall increase in anorexigenic hormonal profile, enhanced post prandial GLP-1 and PYY and inverse to controls changes in urine metabolomics. Overfeeding revealed a paradoxical positive energy balance contemporary to a lack of bodyweight gain, suggesting yet unknown specific energy expenditure pathways in CTs.

Self-seeding-based 10Gb/s over 25km optical OFDM transmissions utilizing face-to-face dual-RSOAs at gain saturation

Self-seeded passive optical networks (PONs) are currently attracting extensive research interest. In this paper, a novel self-seeded PON transmitter is, for the first time, proposed and experimentally demonstrated, which incorporates two face-to-face-positioned reflective semiconductor optical amplifiers (RSOAs) operating at their gain saturation regions: one RSOA directly driven by an upstream electrical signal and the other RSOA biased at a fixed current. Detailed experimental explorations are undertaken of the dynamic performance characteristics of the proposed transmitter. It is shown that, in comparison with previously reported self-seeded transmitters each employing a reflective mirror and a single electrical signal-driven RSOA, the proposed transmitter has a number of salient advantages including, considerably narrowed optical signal spectra, up to 16dB reduction in RINs of intensity-modulated optical signals, and residual intensity modulation crosstalk suppression as high as 10.7dB. The aforementioned features enable experimental demonstrations of real-time self-seeded 10Gb/s optical OFDM (OOFDM) transmitters. In particular, by making use of two low-cost RSOAs having their 3-dB modulation bandwidths as small as 1.125GHz, 10Gb/s over 25km adaptive OOFDM transmissions with power penalties of 0.6dB are experimentally achieved in the simple self-seeded IMDD PON systems.

Record-high and robust 17.125 Gb/s gross-rate over 25 km SSMF transmissions of real-time dual-band optical OFDM signals directly modulated by 1 GHz RSOAs

Aggregated 17.125 Gb/s real-time end-to-end dual-band optical OFDM (OOFDM) transmissions over 25 km SSMF IMDD systems with 7 dB receiver sensitivity improvements are experimentally demonstrated, for the first time, by utilizing low-cost transceiver components such as directly modulated 1GHz RSOAs and DACs/ADCs operating at sampling speeds as low as 4GS/s. The demonstrated OOFDM transceivers have both strong adaptability and sufficiently large passband carrier frequency tunability, which enable full use of highly dynamic spectral characteristics of the transmission systems. This results in the achievements of not only excellent performance robustness to variations in system operating conditions but also significantly relaxed requirements on RSOA small-signal modulation bandwidth. It is shown that the aforementioned transmission capacity only varies by <23% over a RSOA-injected optical power variation range as large as 20dB, and that the 1 GHz RSOAs can support successful transmissions of adaptively modulated OOFDM signals having bandwidths of 8.5 GHz. By taking into account the adopted 25% cyclic prefix and a typical 7.3% FEC overhead, the demonstrated real-time OOFDM transmission systems are capable of conveying 11.6 Gb/s user data.

Robust real-time 15.125 Gb/s adaptive optical OFDM transmissions over 100 m OM2 MMFs utilizing directly modulated VCSELs subject to optical injection locking

Optical injection locking (OIL) is an effective approach for significantly enhancing the modulation bandwidths of VCSELs. The frequency responses of OIL-VCSELs are, however, very sensitive to the applied OIL conditions. This brings about strong difficulties in practically utilizing the OIL-enhanced modulation bandwidths to achieve highly robust transmission performances of directly modulated OIL-VCSEL-based multi-mode fibre (MMF) links for cost-sensitive application scenarios such as data-centers. In this paper, directly modulated OIL-VCSEL-based real-time dual-band optical OFDM (OOFDM) transceivers with tunability in both the electrical and optical domains are experimentally demonstrated, for the first time, utilizing DACs/ADCs at sampling speeds as low as 4GS/s. The transceivers can support 15.125 Gb/s adaptive OOFDM transmissions over 100 m OM2 MMF links based on intensity modulation and direct detection. More importantly, the adaptability and tunability of the demonstrated transceivers enable the achievement of excellent robustness of the aggregated OOFDM transmission capacity to OIL condition variations. It is shown that, over a large diversity of OIL conditions that give rise to significantly different system frequency responses, the aggregated OOFDM transmission capacity only vary by <11% in the aforementioned transmission link.

Diagnostic value of a novel fully automated immunochemistry assay for detection of ALK rearrangement in primary lung adenocarcinoma

BACKGROUND

To evaluate the diagnostic value of a novel fully automated immunohistochemistry (IHC) assay for detection of anaplastic lymphoma kinase (ALK) fusion in a large number of ALK-positive lung adenocarcinoma (ADC) patients.

PATIENTS AND METHODS

We tested 196 lung ADCs for ALK rearrangement by two IHC assays (Ventana pre-diluted ALK D5F3 antibody with the Optiview DAB IHC detection kit and Optiview Amplification kit, D5F3 by Cell Signaling Technology (CST) with Ultraview DAB detection kit by Ventana), fluorescence in situ hybridization (FISH) and real-time reverse transcription-PCR (RT-PCR). CST ALK IHC was scored using the scoring scheme of 0, no staining; 1+, faint; 2+, moderate; and 3+, strong cytoplasmic reactivity in ≥ 10% of tumor cells. As for Ventana IHC, a binary scoring system (positive or negative for ALK status) was adopted for evaluating the staining results.

RESULTS

Among 196 cases tested, 63 (32%), 65 (33%), 70 (36%), and 69 (35%) cases were ALK positive by FISH, Ventana IHC, CST IHC, and RT-PCR, respectively. The sensitivity and specificity of Ventana IHC were 100% and 98%, respectively. Two Ventana IHC-positive cases, which were also CST IHC score of 3+, showed FISH negative, but their ALK rearrangement was confirmed by RT-PCR and direct sequencing. The sensitivity and specificity of CST IHC with staining intensity score of 1+ or more were 100% and 95%, respectively. Five (25%, of 20) patients with CST IHC score of 1+ were both FISH and RT-PCR negative. The sensitivity and specificity of RT-PCR for detection of ALK fusion were 98% and 95%, respectively. The total accordance rate between ALK RT-PCR and Ventana IHC was 97%.

CONCLUSIONS

The novel fully automated IHC assay is a reliable screening tool in routine pathologic laboratories for identification of patients with ALK rearrangement for targeted therapy in lung ADC.

Analysis of genetic diversity among wild bermudagrass germplasm from southwest China using SSR markers

Fifty-five wild accessions of bermudagrass (Cynodon dactylon) were collected from southwest China (Sichuan, Chongqing, Yunnan, Guizhou, and Tibet), and their genetic diversity was analyzed using simple sequence repeat markers. A total of 267 polymorphic bands were detected with 18 primer combinations. The genetic similarity among the accessions ranged from 0.688 to 0.894 with an average of 0.797. All 55 wild accessions were clustered into 7 eco-geographic groups. Our data showed that the dendrogram was almost in accordance with geographic distribution, and accessions from the same collection sites tended to be clustered into the same group. A genetic differentiation analysis revealed that the percentage of genetic variance was 70.07 and 29.93% within and among groups, respectively. Finally, we discuss the implications of these results for C. dactylon in southwest China.

IL-17 and IFN-γ production in peripheral blood following BCG vaccination and Mycobacterium tuberculosis infection in human

BACKGROUND

During Mycobacterium tuberculosis (Mtb) infection, cells of the immune system rely on cytokines to regulate the activity of other immune and structural cells such as IFN-gamma and IL-4. Recent studies suggest that Th17 cells secreting IL-17 may play a potential role in tuberculosis (TB) development.

AIM

To assess the effect of IL-17 on TB development, we provide a systematic review on the production of IL-17, IFN-gamma and IL-4 in infants or children vaccinated with BCG and in TB patients.

MATERIALS AND METHODS

The literature relevant with IL-17 and IFN-gamma production with or without IL-4 on human TB was retrieved from PubMed, EMBASE, Cochrane Library, BIOSIS Previews and the China Biomedicine Literature Databases (CBM) using the search terms "Interleukin-17 or Th17 cells" and "Tuberculosis". The information of included studies, the production of IL-17 and IFN-gamma responding to antigens in the peripheral blood in vitro, was independently extracted by the first two researchers and subsequently qualitatively analyzed.

RESULTS

Nine studies from a total of 226 retrieved publications met the criteria. These included studies showed that BCG vaccination induced dramatically high level of IL-17 similar to IFN-gamma; The level of IL-17 and IFN-gamma were low while IL-4 was high in patients with active TB; IL-17 and IFN-gamma had a similar trend of increase during the conversion from active to latent TB while IL-4 inclined to decrease in this process.

CONCLUSIONS

IL-17 acts as an effector molecule similar to IFN-gamma after BCG vaccination and Mtb infection to protect human against TB. The current findings do not support IL-17 as an inducer of tissue damage in TB.

p14ARF repression induced by promoter methylation associated with metastasis in esophageal squamous cell carcinoma

The objective of this study is to evaluate the promoter methylation status of the p14ARF in esophageal squamous cell carcinoma (ESCC). Cell lines were treated with the demethylation agent 5-aza-2'-deoxycytidine, and p14ARF messenger RNA (mRNA) expression was detected by reverse transcription-polymerase chain reaction. We analyzed the methylation status of p14ARF promoter by methylation-specific polymerase chain reaction in 50 ESCC and their noncarcinoma tissues. Then demethylation caused by 5-aza-2'-deoxycytidine increased the p14ARF mRNA expression level in esophagus cancer cell lines. p14ARF methylation was found in 48% (24 of 50) of ESCC patients but only in 18% (9 of 50) corresponding noncarcinoma tissues (P = 0.001). There was a statistically significant correlation between the presence of methylation and tumor metastasis (P < 0.001). The p14ARF mRNA was lower in ESCC tissues than nontumor tissues (mean ± standard deviation, 0.47 ± 0.32 vs. 1.40 ± 0.58; P = 0.002). Meanwhile, a signification association was found between the methylation status of p14ARF promoter and p14ARF mRNA expression in tissues (P < 0.05). The aberrant promoter methylation of p14ARF is a common phenomenon in ESCC, which may be an important mechanism of downregulating p14ARF mRNA expression.

Identification of chicken eNOS gene and differential expression in highland versus lowland chicken breeds

Nitric oxide (NO), an endothelium-derived relaxing factor, is synthesized from l-arginine by endothelial nitric oxide synthase (eNOS) in the endothelium. The objective of the present study was to preliminarily illuminate the expression of the eNOS gene in hypoxic adaptation of chicken embryonic development. The eNOS expression profiles between the Tibet and Shouguang chickens incubated under both normoxic and hypoxic conditions were detected by TaqMan real-time PCR. In this study, the chicken eNOS gene was found by both in silico cloning and RACE approaches. From the eNOS gene, we obtained a 3,310-bp mRNA sequence and a 10,666-bp DNA sequence and discovered that it was located on chicken chromosome 2 and had 7 unique transcripts. eNOS mRNA was detected in abundant amounts in some chick embryo organs (i.e., heart, liver, chorio-allantoic membrane, and lung), and expressed stably with the lowest levels in the brain. We observed that when exposed to hypoxia (13% O(2)) different embryo organ tissues had various sensitivities to hypoxia as determined by their eNOS expression profiles. Compared with the Shouguang chicken, the eNOS expression in the Tibet chicken was higher in the lung and liver, lower in the heart, and similar in the brain. In chorio-allantoic membranes, eNOS expression was higher in the Shouguang chicken than the Tibet chicken under hypoxic conditions, but not markedly different under normoxic conditions. The differences of eNOS expression between the 2 breeds may be relative to the hypoxic adaptation ability in Tibet chickens during embryonic development. This work will provide reference for future studies on the role of eNOS in hypoxic adaptation and response.

Increased lipolysis in adipose tissues is associated with elevation of systemic free fatty acids and insulin resistance in perilipin null mice

Elevated plasma levels of free fatty acids (FFAs) are thought to restrict glucose utilization and induce insulin resistance. Plasma FFA concentrations are primarily governed by lipolysis in adipocytes. Perilipin surrounds the lipid droplet in adipocytes and has a dual role in lipolysis regulation. Perilipin null mice studied by two independent laboratories exhibited similar phenotypes of reduced adipose mass and resistance to diet-induced obesity, but have inconsistent metabolic parameters such as plasma levels of FFA, glucose, and insulin. This discrepancy may be due to differences in genetic background, generation, and nutritional status of the animals examined. In this study, we examined the major metabolic parameters in 129/SvEv perilipin null mice fasted for 4 h and observed increased plasma concentrations of FFA, glycerol, glucose, and insulin. An increase in the score for the homeostasis model assessment of insulin resistance index confirmed the insulin resistance in perilipin null mice, which may be attributed to the plasma FFA elevation. Basal lipolysis was increased in adipose tissues or primary adipocytes isolated from perilipin null mice with increased mass and activity of hormone-sensitive lipase and adipose triglyceride lipase. The increased lipolytic action may accelerate FFA efflux from the adipose tissues to the bloodstream, thereby accounting for systemic FFA elevation and, hence, insulin resistance in perilipin null mice.

Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes

OBJECTIVE

To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes.

METHODS

After a 2 week placebo run-in period, eligible patients inadequately controlled on long-acting, intermediate-acting or premixed insulin (HbA1c > or = 7.5% and < or = 11%), were randomised 1:1 to the addition of once-daily sitagliptin 100 mg or matching placebo over a 24-week study period. The study capped the proportion of randomised patients on insulin plus metformin at 75%. Further, the study capped the proportion of randomised patients on premixed insulin at 25%. The metformin dose and the insulin dose were to remain stable throughout the study. The primary endpoint was HbA1c change from baseline at week 24.

RESULTS

Mean baseline characteristics were similar between the sitagliptin (n = 322) and placebo (n = 319) groups, including HbA1c (8.7 vs. 8.6%), diabetes duration (13 vs. 12 years), body mass index (31.4 vs. 31.4 kg/m(2)), and total daily insulin dose (51 vs. 52 IU), respectively. At 24 weeks, the addition of sitagliptin significantly (p < 0.001) reduced HbA1c by 0.6% compared with placebo (0.0%). A greater proportion of patients achieved an HbA1c level < 7% while randomised to sitagliptin as compared with placebo (13 vs. 5% respectively; p < 0.001). Similar HbA1c reductions were observed in the patient strata defined by insulin type (long-acting and intermediate-acting insulins or premixed insulins) and by baseline metformin treatment. The addition of sitagliptin significantly (p < 0.001) reduced fasting plasma glucose by 15.0 mg/dl (0.8 mmol/l) and 2-h postmeal glucose by 36.1 mg/dl (2.0 mmol/l) relative to placebo. A higher incidence of adverse experiences was reported with sitagliptin (52%) compared with placebo (43%), due mainly to the increased incidence of hypoglycaemia (sitagliptin, 16% vs. placebo, 8%). The number of hypoglycaemic events meeting the protocol-specified criteria for severity was low with sitagliptin (n = 2) and placebo (n = 1). No significant change from baseline in body weight was observed in either group.

CONCLUSION

In this 24-week study, the addition of sitagliptin to ongoing, stable-dose insulin therapy with or without concomitant metformin improved glycaemic control and was generally well tolerated in patients with type 2 diabetes.

Influences of hypoxia on hatching performance in chickens with different genetic adaptation to high altitude

The experiments were conducted to assess how hatching performance is affected by chicken breeds and environment of high altitude and to analyze the vital factor of the low hatchability at a 2,900-m altitude. Eggs of Tibetan and Dwarf chickens were incubated at conditions of normobaric normoxia, normobaric hypoxia, hypobaric hypoxia, and supplemental O2 at high altitude (hypobaric normoxia) during the whole incubation or at 0 to 7, 8 to 14, and 15 to 22 d of incubation, respectively. The results showed that the Tibetan chickens had greater hatchability (79.72%), lower water loss (12.90%), greater relative embryo weight (38.08%), and relative chick weight (68.41%) compared with the Dwarf chickens (31.69, 15.79, 30.71, and 65.21%, respectively) when both of them were incubated at a 2,900-m altitude. The hatchability was 71.60% in Tibetan chicken and 36.23% in Dwarf chicken under the normobaric hypoxia condition. The hatchability of chicken was efficiently increased with supplemental O2. The previous results indicated that the O2 deficit is the main factor resulting in the low hatchability and the poor chick quality of the lowland chicken breed when incubated at a 2,900-m altitude. Breeding chickens for adaptability to hypoxia and supplemental O2 is a good way to improve the hatchability and chick quality at that altitude.

A SNP in the ACT gene associated with astrocytosis and rapid cognitive decline in AD

There is biochemical and animal model evidence supporting a pathological role of the ACT gene in AD. However, direct genetic evidence remains controversial and has been mostly limited to individual single nucleotide polymorphism (SNP) analysis. To resolve this apparent conflict we have used a high-density ACT SNP map, constructed haplotypes and explored correlations with phenotype. SNPs were identified by sequencing and used to construct haplotypes in 668 AD patients and 419 controls and a case-control association study was performed. Five SNPs, comprising five common haplotypes, represented 93% of ACT gene variation. Although no single SNP or haplotype was associated with AD status, a SNP in intron 2 was associated with later onset and more rapid cognitive decline (P=0.04). This SNP was both individually associated with severe astrocytosis (P=0.004) in AD patients and when combined with the signal sequence SNP (P=0.002). This suggests that astrocytosis may have a protective function for a limited period in some patients. These SNP associations either support a direct role for the ACT gene, in AD pathology or alternatively reflect linkage with polymorphisms in other genes nearby.

ERCC1 mRNA levels and survival of advanced gastric cancer patients treated with a modified FOLFOX regimen

Molecular markers involved in DNA repair can help to predict survival in gastric cancer patients treated with 5-FU plus platinum chemotherapy. Excision repair cross-complementing 1 (ERCC1) and thymidylate synthase (TS) mRNA expression levels were assessed in advanced gastric cancer tumour samples using real-time quantitative PCR in 76 patients treated with a modified FOLFOX (biweekly oxaliplatin plus 5-FU and folinic acid) regimen. Median survival time in patients with low ERCC1 levels was significantly longer than in those with high levels (15.8 vs 6.2 months; P<0.0001). Patients with high TS levels had longer survival than those with low levels (12.2 vs 10.1 months; P=0.01). Forty-eight patients with low ERCC1 and high TS levels had a median survival of 16.1 months (P<0.0001). The hazard ratio for patients with high ERCC1 expression was 9.4 (P<0.0001). In patients with high mRNA levels of ERCC1, alternative chemotherapy regimens should be considered.