[Depletion of PRDM9 inhibited the osteogenic differentiation potential of periodontal ligament stem cells]

Objective: To investigate the effect of PR domain zinc finger protein 9 (PRDM9), one of the histone methylated transferases, on osteogenic differentiation ability of periodontal ligament mesenchymal stem cells (PDLSC). Methods: PDLSC with PRDM9 gene knocked down by PRDM9 shRNA using recombinant lentiviral vector were allocated into the PRDM9sh group, and the transfected shRNA was as the control group. The gene expression efficiency was evaluated by reverse transcription polymerase chain reaction (RT-PCR). Alkaline phosphatase activity (ALP), alizarin red staining, mineralization and osteocalcin, which belongs to osteogenic differentiation markers detected by RT-PCR and Western blotting to detect the osteogenic differentiation ability of stem cells from periodontal ligaments in vitro. In vivo, PRDM9sh and control group cells was transplanted into the dorsal dermal to explore the osteogenesis. The area percentage of new osteogenic tissue was calculated by image pro software and statistically analyzed. Results: RT-PCR results showed that the relative expression of PRDM9 gene in PRDM9sh (0.460±0.017) was significantly lower than that in control group (1.000±0.107) (P<0.05). The results of ALP activity determined at 5 days postinduction in a significant decrease in PRDM9sh cells (0.762±0.063) compared with control group (1.225±0.058) (P<0.01). Alizarin red staining induced by osteogenesis at 2 weeks and 3 weeks showed that the staining of PRDM9sh was significantly lighter than that in control group. Quantitative calcium analysis results showed that the calcium ion concentration induced by osteogenesis at 2 weeks and 3 weeks [(0.071±0.004), (0.075±0.001)] in PRDM9sh was significantly lower than that in control group at 2 weeks and 3 weeks [(0.282±0.006), (0.485+0.004)] (P<0.01). RT-PCR results showed that the relative expression of osteocalcin mRNA in PRDM9sh (1.059±0.148) was significantly lower than that in control group at 2 weeks (2.542±0.190) (P<0.01). Western blotting results showed that osteocalcin expression in PRDM9sh was significantly lower than that in control group at 1 and 2 weeks after osteogenesis induction. Animal transplantation experiments results indicated that PRDM9 significantly inhibited the osteogenesis of PDLSC in vivo, and the proportion of osteogenic area calculated showed that the osteogenic capacity of PRDM9sh [(3.8±2.41)%] was significantly lower than that in control group [(24.54±7.06)%](P<0.05). Conclusions: Depletion of PRDM9 repressed the osteogenic differentiation of stem cells from periodontal ligament in vitro and in vivo.

[Curative effect observation of application of the snare in epiglottic cystectomy by arc-shaped laryngoscopy]

Objective:To evaluate the effect of the epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare. Method:The clinical data of 42 patients with epiglottic cysts were retrospectively analyzed. Forty-two patients with epiglottis cyst were treated by arc-shaped video laryngoscopy combined with snare. Result:All 42 cases were completely resected at one time without obvious complications and the cure rate was 100%. Moreover, the short operation time（5-20 min） and the minor hemorrhage（1-10 ml） were observe. There was no recurrence after 6 to 33 months follow-up. Conclusion:The epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare has the advantages of broad vision, easy operation, minimal invasion, rapid recovery and good curative effect, it is worthy to be popularized in clinical application.

LncRNA PCAT-1 regulates the proliferation, metastasis and invasion of cervical cancer cells

OBJECTIVE

To investigate the effects of long non-coding RNA (lncRNA) PCAT-1 on the proliferation, metastasis, and invasion of cervical cancer cells.

MATERIALS AND METHODS

LncRNA PCAT-1 small interfering RNA (siRNA) and negative siRNA were transfected into cervical cancer cell lines and the expression of lncRNA PCAT-1 in cells was confirmed by Real-time quantitative polymerase chain reaction (qPCR). Cell counting kit-8 (CCK-8) and colony formation assay were applied to detect the effect of lncRNA PCAT-1 on cell proliferation. The wound-healing assay was applied to test the effect of lncRNA PCAT-1 on cell metastasis. Matrigel cell invasion assay was performed to detect the impact of lncRNA PCAT-1 expression on invasion.

RESULTS

After transfected with the long non-coding PCAT-1 siRNA into cervical cancer cell lines for 48 h, the lncRNA PCAT-1 cells were significantly down-regulated. The results of CCK-8, clonogenic and wound-healing assay showed that the decreased expression of lncRNA PCAT-1 attenuated the proliferation and metastasis of cells. The results of matrigel cell invasion assay manifested that the decreased expression of lncRNA PCAT-1 could reduce the invasion ability. The up-regulation of lncRNA PCAT-1 was associated with poor prognosis of patients with cervical cancer.

CONCLUSIONS

LncRNA PCAT-1 siRNA transfected into cervical cancer cell lines can effectively lower the expression of lncRNA PCAT-1, while lncRNA PCAT-1 expression can inhibit the proliferation, metastasis and invasion abilities of cervical cancer cells.

Electrophysiological effects of melatonin on rat trigeminal ganglion neurons that participate in nociception in vitro

OBJECTIVE

Melatonin (MT) is a hormone mainly produced by the pineal gland. It may be involved in the regulation of nociception, the mechanisms of which remain unclear. In the present study, electrophysiological effects of MT on neurons were studied.

MATERIALS AND METHODS

The cultured neurons were isolated from Sprague-Dawley rats trigeminal ganglia (TG). The neuron was voltage clamped using the whole cell patch clamp technique. We recorded resting membrane potential, action potential threshold and number, action potential duration and GABA-activated inward currents in the presence of 0.01 μM, 10 μM MT, and in the absence of MT.

RESULTS

In the presence of high concentration of MT, the spontaneous action potential disappeared and action potential threshold was significantly increased. GABA-activated inward currents were recorded and blocked by GABAA receptor antagonist, bicuculline, in the majority of TG neurons (91% 40/44). Continuous perfusion of MT could cause a decrease of GABA-activated currents. The inhibiting effect was dose-dependent and irreversible.

CONCLUSIONS

The results suggest that MT has several electrophysiological effects on TG neurons, which may be involved in the peripheral mechanisms of orofacial pain.

Kaempferol attenuates imiquimod-induced psoriatic skin inflammation in a mouse model

Psoriasis is an immune-mediated inflammatory skin disease that mainly affects the skin barrier. Treatment for psoriasis mainly includes conventional immunosuppressive drugs. However, long-term treatment with global immunosuppressive agents may cause a variety of side effects, including nephrotoxicity and infections. Kaempferol, a natural flavonol present in various plants, is known to possess potent anti-inflammatory, anti-oxidant and anti-cancerous properties. However, it is unknown whether kaempferol is also anti-psoriatic. Here we established an imiquimod (IMQ)-induced psoriatic mouse model to explore the potential therapeutic effects of kaempferol on psoriatic skin lesions and inflammation. In this study, we demonstrated that treatment with kaempferol protected mice from developing psoriasis-like skin lesions induced by topical administration of IMQ. Kaempferol reduced CD3⁺ T cell infiltration and gene expression of major proinflammatory cytokines, including interleukin (IL)-6, IL-17A and tumor necrosis factor (TNF)-α, in the psoriatic skin lesion. It also down-regulated proinflammatory nuclear factor kappa B (NF-κB) signaling in the skin. The therapeutic effects were associated with a significant increase in CD4⁺ forkhead box protein 3 (FoxP3)⁺ regulatory T cell (T_reg ) frequency in the spleen and lymph nodes as well as FoxP3-positive staining in the skin lesion. Conversely, depletion of CD4⁺ CD25⁺ T_regs reversed the therapeutic effects of kaempferol on the skin lesion. Kaempferol also lowered the percentage of IL-17A⁺ CD4⁺ T cells in the spleen and lymph nodes of IMQ-induced psoriatic mice. Finally, kaempferol suppressed the proliferation of T cells in vitro and their mTOR signaling. Thus, our findings suggest that kaempferol may be a therapeutic drug for treating human psoriasis in the near future.

[The establishment and influence of the Prescription Appraisal Committee of the Central National Physician Pavilion]

The Prescription Appraisal Committee of the Central National Physician Pavilion was established on November 8, 1935. It specializes in handling cases where the parties entrusted by the Court have applied for re-identification against the identification of the local Chinese Medicine branch or medical group.The statutes of the Prescription Appraisal Committee stipulate the entrusted appraisers, the scope of appraisal, the appraisers, the appraisal process, and the signing and service of the appraisal opinions for the re-identification of TCM cases. To a certain extent, it played a role in improving the medical service environment of Chinese medicine at that time, safeguarding the common interests of doctors and patients, and promoting the institutionalized development of appraisal of Chinese medicine lawsuits in the Republic of China. However, due to historical reasons and limitations, it also had inherent limitations such as the uneven geographical distribution of appraisal candidates, the lack of strict identification procedures, and the inconsistency of appraisal standards.

Bacillus licheniformis, a potential probiotic, inhibits obesity by modulating colonic microflora in C57BL/6J mice model

AIMS

This study evaluated the effects of a potential probiotic, Bacillus sp., on the growth, serum and hepatic triglyceride, histological features of liver tissues and colonic microflora in high-fat diet-induced obese mice.

METHODS AND RESULTS

Sixty male C57BL/6J mice were randomly divided into five groups: mice fed a low-fat diet (Cont), mice fed a high-fat diet (Hf), Hf and orally challenged with Bacillus subtilis (Bs), B. licheniformis (Bl) and a mixture of B. subtilis and B. licheniformis (Bls). Gavage feeding was provided at week 9 and the experiment was continued for 8 weeks. Treatment with B. licheniformis and a mixture of Bacillus sp. attenuated body weight gain at the end of study and enhanced glucose tolerance by sensitizing insulin action in the Hf-fed mice. Lower serum and hepatic triglyceride and epididymal fat weight were observed in Bl and Bls groups than that of Hf group. Lesser hepatic fat deposition was observed in the Bl and Bls groups than in the Hf group. High-throughput sequencing showed that Bacillus sp. supplementation dramatically changed the colonic bacterial community in obese mice.

CONCLUSIONS

Bacillus licheniformis reduced body weight and improved glucose tolerance, obesity and insulin resistance in Hf-fed mice by changing colonic microbiota composition.

SIGNIFICANCE AND IMPACT OF THE STUDY

Orally administration of Bacillus licheniformis may reduce body weight and decrease fat deposition by modulating colonic bacterial community in Hf model.

[Application of U-shaped convolutional neural network in auto segmentation and reconstruction of 3D prostate model in laparoscopic prostatectomy navigation]

OBJECTIVE

To investigate the efficacy of intraoperative cognitive navigation on laparoscopic radical prostatectomy using 3D prostatic models created by U-shaped convolutional neural network (U-net) and reconstructed through Medical Image Interaction Tool Kit (MITK) platform.

METHODS

A total of 5 000 pieces of prostate cancer magnetic resonance (MR) imaging discovery sets with manual annotations were used to train a modified U-net, and a set of clinically demand-oriented, stable and efficient full convolutional neural network algorithm was constructed. The MR images were cropped and segmented automatically by using modified U-net, and the segmentation data were automatically reconstructed using MITK platform according to our own protocols. The modeling data were output as STL format, and the prostate models were simultaneously displayed on an android tablet during the operation to help achieving cognitive navigation.

RESULTS

Based on original U-net architecture, we established a modified U-net from a 201-case MR imaging training set. The network performance was tested and compared with human segmentations and other segmentation networks by using one certain testing data set. Auto segmentation of multi-structures (such as prostate, prostate tumors, seminal vesicles, rectus, neurovascular bundles and dorsal venous complex) were successfully achieved. Secondary automatic 3D reconstruction had been carried out through MITK platform. During the surgery, 3D models of prostatic area were simultaneously displayed on an android tablet, and the cognitive navigation was successfully achieved. Intra-operation organ visualization demonstrated the structural relationships among the key structures in great detail and the degree of tumor invasion was visualized directly.

CONCLUSION

The modified U-net was able to achieve automatic segmentations of important structures of prostate area. Secondary 3D model reconstruction and demonstration could provide intraoperative visualization of vital structures of prostate area, which could help achieve cognitive fusion navigation for surgeons. The application of these techniques could finally reduce positive surgical margin rates, and may improve the efficacy and oncological outcomes of laparoscopic prostatectomy.

[Spectrometric analyses of larotaxel and larotaxel liposomes quantification by high performance liquid chromatography]

OBJECTIVE

Larotaxel is a new chemical structure drug, which has not been marketed worldwide. Accordingly, the standard identification and quantification methods for larotaxel remain unclear. The spectrometric analyses were performed for verifying weight molecular formula, molecular weight and chemical structure of larotaxel. Besides, a quantification method was developed for measuring larotaxel in the liposomes.

METHODS

The molecular formula, molecular weight and chemical structure of larotaxel were studied by using mass spectrometry (MS), infra-red (IR), nuclear magnetic resonance (NMR) and ultraviolet-visible (UV-vis) spectrometric techniques. The absorption wavelength of larotaxel was investigated by UV-vis spectrophotometry full-wavelength scanning. Besides, a quantification method was developed by high performance liquid chromatography (HPLC), and then validated by measuring the encapsulation efficacy of larotaxel liposomes.

RESULTS

The four spectral characteristics of larotaxel were revealed and the corresponding standard spectra were defined. It was confirmed that larotaxel had the structure of tricyclic diterpenoids, with the molecular formula of C45H53NO14, the molecular weight of 831.900 1, and the maximum absorption wavelength of 230 nm. The quantitative method of larotaxel was established by using HPLC with a reversed phase C18 column (5 μm, 250 mm×4.6 mm), a mobile phase of acetonitrile-water (75:25, volume/volume), and a detection wavelength of 230 nm. The validation study exhibited that the established HPLC method was stable, and had a high recovery and precision in the quantitative measurement of larotaxel in liposomes. In addition, a new kind of larotaxel liposomes was also successfully prepared. The particle size of the liposomes was about 105 nm, with an even size distribution. And the encapsulation efficiency of larotaxel in the liposomes was above 80%.

CONCLUSION

The present study offers reference standard spectra of larotaxel, including MS, IR, NMR, and UV-vis, and confirms the molecular formula, molecular weight and chemical structure of larotaxel. Besides, the study develops a rapid HPLC method for quality control of larotaxel liposomes.

[The role of body fat rate in the evaluation of obstructive sleep apnea]

Objective: To investigate the role of body fat ratio in the evaluation of obstructive sleep apnea(OSA). Methods: A retrospective analysis was made on 174 cases (between November, 2017 and April, 2018 showed that) of sleep monitoring in the Department of Otorhinolaryngology in Peking University Third Hospital. The data included the gender, age, body fat rate, body mass index (BMI), neck circumference, and apnea-hypopnea index (AHI). The above data were analyzed by non parametric correlation analysis, receiver operating characterristic (ROC) curve analysis and multiple factor Logistic regression analysis to study the relationship between the gender,age,body fat rate,BMI,neck circumference and other indexes of the patients with AHI. Results: Nonparametric correlation analysis showed that the correlation from strong to weak to AHI among women was BMI (r=0.621, P<0.001),body fat rate (r=0.602, P<0.001), age (r=0.570, P<0.001), neck circumference (r=0.402, P=0.014), respectively. BMI (r=0.599, P<0.001), neck circumference (r=0.493, P<0.001), body fat rate (r=0.318, P<0.001), and age (r=0.256, P=0.003) among men. ROC curve analysis showed that the strong to weak index (area under curve,AUC) of the AHI>15/h among women was the body fat rate (AUC=0.884, P=0.001), BMI(AUC=0.810, P=0.008), neck circumference (AUC=0.759, P=0.027), age (AUC=0.750, P=0.033), and the male was BMI (AUC=0.765,P<0.001), neck circumference (AUC=0.720, P<0.001), age (AUC=0.634, P=0.008), and body fat rate (AUC=0.632, P=0.010), respectively. Multifactor Logistic regression analysis showed that the body fat rate (OR=1.704,95%CI=1.012-2.870) in women was an independent risk factor for AHI greater than 15/h; the age of male (OR=1. 044, 95%CI=1.005-1.085) and BMI (OR=1.285, 95%CI=1.056-1.562) were independent risk factors for AHI greater than 15/h. Conclusion: Body fat rate can be used as a new indicator for predicting the severity of OSA,especially in adult female population. In adult female moderate to severe OSA patients (AHI>15/h), compared with BMI,neck circumference and age,the body fat rate has the greatest correlation with AHI. Compared with BMI,neck circumference and age,the body fat rate has a decisive role in predicting moderate to severe OSA (AHI>15/h).

Expression patterns and colocalization of two sensory neurone membrane proteins in Ectropis obliqua Prout, a geometrid moth pest that uses Type-II sex pheromones

Sensory neurone membrane proteins (SNMPs) function as essential cofactors for insect sex pheromone detection. In this study, we report two SNMPs in Ectropis obliqua Prout, a serious geometrid pest that produces typical Type-II sex pheromones. Sequence alignments and phylogenetic analyses showed that EoblSNMP1 and EoblSNMP2 belong to two distinct SNMP subfamilies. Quantitative real-time PCR suggested that EoblSNMP1 was male antennae-biased, whereas EoblSNMP2 was highly expressed on male antennae but was also expressed on female antennae and other chemosensory tissues. Additionally, EoblSNMP1 and EoblSNMP2 differed in their developmental expression profiles. In situ hybridization revealed that EoblSNMP1 was sensilla trichodea I specific, whereas EoblSNMP2 was expressed in sensilla trichodea I and the sensilla basiconica; furthermore, EoblSNMP1 and EoblSNMP2 were co-expressed in sensilla trichodea I but in different cells. This study suggests that EoblSNMP1 is functionally distinct from EoblSNMP2 in E. obliqua; EoblSNMP1 may specifically contribute to the recognition of sex pheromones, whereas EoblSNMP2 exhibits multiple olfactory roles. Our findings comprehensively reveal the expression patterns of SNMPs in a lepidopteran species that uses Type-II sex pheromones, providing new insights into the functional evolution of SNMPs from lepidopteran moths with Type-I sex pheromones to those with Type-II sex pheromones.

Genomic targeting by recombinase-mediated cassette exchange in the spotted wing drosophila, Drosophila suzukii

Drosophila suzukii is a significant pest of stone and small fruits. The genome of this species has been sequenced and manipulated by transposon-mediated transformation and CRISPR/Cas9 gene editing. These technologies open a variety of possibilities for functional genomics and genetic modifications that might improve biologically based population control strategies. Both of these approaches, however, would benefit from genome targeting that would avoid position effects and insertional mutations associated with random transposon vector insertions, and the limited DNA fragment insertion size allowed by gene editing. Here, we describe an efficient recombinase-mediated cassette exchange (RMCE) system for D. suzukii in which heterospecific lox recombination sites were integrated into the genome by transposon-mediated transformation and subsequently targeted for double recombination by a donor vector in the presence of Cre recombinase. Three loxN/lox2272 landing site lines have previously been created in D. suzukii, and quantitative PCR determined that polyubiquitin-regulated enhanced green fluorescent protein expression is least susceptible to position effect suppression in the 443_M26m1 line. We presume that RMCE target sites may also be inserted more specifically into the genome by homology-directed repair gene editing, thereby avoiding position effects and mutations, while eliminating restrictions on the size of donor constructs for subsequent insertion.

Uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus patient with pulmonary arterial hypertension: case report

We reported uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus with pulmonary arterial hypertension. Choroidal retinopathy is rare but extremely destructive to visual function. Therefore, prompt diagnosis and effective treatments will result in complete resolution of the uveal effusion and functional restoration of vision.

Competitive interaction on dual-species biofilm formation by spoilage bacteria, Shewanella baltica and Pseudomonas fluorescens

AIMS

This study aims to characterize the biofilm produced by mono- and dual-species of Shewanella baltica and Pseudomonas fluorescens as fish spoilers at the different incubation temperature, and to elucidate the interactive behaviour of dual-species biofilm development.

METHODS AND RESULTS

The mono- and dual-species biofilm formation and adhesion characteristics of S. baltica and P. fluorescens were evaluated by using crystal violet staining, scanning electron microscopy and confocal laser scanning microscopy. Results showed that P. fluorescens had significantly higher biofilm biomass and polysaccharides production than S. baltica, and two isolates reached the maximum biofilm biomass during the early stationary phase. Lower biomass and polysaccharides in dual-species biofilms were observed compared to mono-species of P. fluorescens. Meanwhile, S. baltica and P. fluorescens formed fragile and viscous pellicles with different spatial architectures respectively. In dual-species pellicle few large microcolonies were dominated by P. fluorescens. Compared to mono-species of PF07, adherent cell population and biofilm thickness at the developing phase significantly decreased, and biofilm-forming cycle prolonged in the dual-species biofilms. Biofilm formation and adhesion of mono- and dual-species at 4 or 15°C were significantly higher than at 30°C during the same phase. The culture supernatant extracts of the two spoilage strains greatly inhibited biofilm development to each other.

CONCLUSIONS

Shewanella baltica and P. fluorescens had different biofilm and pellicle characteristics, and the inhibitory development on dual-species biofilm was associated with the competitive interaction by the two psychrotrophic spoilage bacteria.

SIGNIFICANCE AND IMPACT OF THE STUDY

This work contributes to a better understanding of interactive behaviour of multispecies biofilm communities by psychrotrophic spoilage bacteria at low temperature, which could contribute to further control contamination of spoilage organism during the preservation and processing of aquatic products.

Histopathological features of antrochoanal polyps in Chinese patients

BACKGROUND

The pathogenesis and etiology of antrochoanal polyps (ACP) are unclear. The aim of this study is to characterize the features of inflammatory cellular infiltration, the epithelial remodeling patterns and their associations to clinical parameters in ACP.

METHODS

A detailed histological study employing classic immunohistochemistry was performed. 33 ACPs, 49 classic bilateral nasal polyps (BNP) and 50 controls were obtained. The histological patterns and inflammatory cells infiltration were evaluated and analyzed for associations with clinical characteristics.

RESULTS

Less severe epithelial hyperplasia and goblet cell hyperplasia were found in ACP compared to BNP. In ACP, 87.9% of cases demonstrated neutrophilia. Elevated proportions of macrophages and CD8+ T cells, and elevated infiltration of mast cells was observed. Eosinophil infiltration was found to be positively corelated with a history of asthma; macrophages proportion was analyzed to have a significantly negative correlation with epithelial hyperplasia and goblet cell hyperplasia; the infiltration of CD8+ T cell and squamous metaplasia were found to have a positive correlation.

CONCLUSION

Inflammation potentially has important roles in ACP. ACP may differ in its pathogenesis from classic bilateral nasal polyps.

Adipogenic/lipogenic gene expression and fatty acid composition in chuck, loin, and round muscles in response to grain feeding of Yanbian Yellow cattle

We hypothesized that gene expression and fatty acid composition would differ among different muscle depots and over time on a grain-based finishing diet. Additionally, we hypothesized that the concentration of SFA would decrease and the concentration of MUFA would increase proportionately with increases in percent intramuscular lipid (%IML). Ten Yanbian Yellow cattle steers (approximately 8 mo of age) were fed a corn-based diet in which the proportion of corn in the ration was increased at 4-mo intervals. Muscle samples were taken by biopsy from the chuck (trapezius), loin (longissimus dorsi), and round (biceps femoris) muscles at 12, 16, 20, 24, and 28 mo of age. The %IML increased from 12 to 28 mo of age, especially between 24 and 28 mo of age, with loin > round > chuck (age × muscle interaction P < 0.001). The percentage (g/100 g total fatty acids) of oleic acid (18:1n-9), linoleic acid (18:2n-6), and α-linolenic acid (18:3n-3), and the MUFA:SFA ratio increased with age, whereas palmitic (16:0) and stearic acid (18:0) decreased with age in all muscles (age effect P < 0.001). The expression of sterol regulatory element binding protein (SREBP1), adipose tissue fatty acid- binding protein (FABP4), stearoyl-CoA desaturase (SCD), acetyl-CoA carboxylase (ACC1), and lipoprotein lipase (LPL) increased, whereas the expression of peroxisome proliferator-activated receptor gamma (PPARγ) and fatty acid synthase (FASN) decreased with age. Expression of PPARγ, FABP4, SREBP1, SCD, FASN, ACC1, and LPL was greater in the loin than in the chuck or round (age × muscle interaction P < 0.001), although the MUFA:SFA ratio was greater in the chuck than in the loin or round (muscle effect P < 0.001). In conclusion, adipogenic gene expression was greater in the loin than in the chuck or round muscles, consistent with the greater %IML of the loin. However, the greater SCD gene expression in the loin did not result in a greater amount of MUFA in the loin, relative to the chuck and round.

Body mass index and the risk of mortality among Chinese adults with Type 2 diabetes

AIMS

To examine the associations between BMI and the risks of all-cause, cardiovascular disease (CVD)-specific and cancer-specific mortality among people with Type 2 diabetes, and thus provide recommendations for weight management in the population.

METHODS

This retrospective cohort study was conducted among 52 763 people with newly diagnosed Type 2 diabetes between 1 January 2004 and 31 December 2014 in Shanghai, China. All cases of death were identified by linking to the Shanghai Vital Statistics. Some 52 488 people were included in the analysis. Survival curves for people with different BMI categories were plotted using the Kaplan-Meier method. Cox proportional hazard models within or without restricted cubic spline functions were applied to examine the potential non-linear or linear relationship between BMI and the risk of mortalities respectively.

RESULTS

A total of 4777 deaths were identified during an average of 6-year follow-up. An L-shaped association was observed between BMI and all-cause mortality in men (P for overall association < 0.001 and P for non-linearity < 0.001) while a U-shaped association was found in women (P for overall association < 0.001 and P for non-linearity< 0.001). In men, no significant association was observed for BMI with cancer-specific and CVD-specific mortality. In women, an increased risk of cancer-specific mortality was observed with increasing BMI, whereas decreasing BMI was associated with the increased CVD-specific mortality rate.

CONCLUSION

The increased all-cause mortality in men with low BMI and in women with either low or high BMI indicate the importance of keeping BMI in a normal range for Chinese adults with Type 2 diabetes.

[Peritoneal dialysis-related eosinophilic peritonitis: a case report and literature review]

Peritoneal dialysis (PD)-related peritonitis is recognized as a common complication of peritoneal dialysis. Eosinophilic peritonitis is a rare type of non-infection PD-related peritonitis. Eosinophilic peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients was first reported in 1967. The cause of eosinophilic peritonitis is obscure, however it may be related to some etiologies: (1) hypersensitivity to PD materials, including catheter or dialysate; (2) bacteria, fungal or mycobacterium tuberculosis infection. Clinical investigations include asymptomatic cloudy PD effluent, fever, abdominal pain and eosinophil count elevate in PD effluent. Eosinophilic peritonitis is usually mild and self-limited. With the development of PD, more eosinophilic peritonitis cases and researches were reported. Here, we report a patient on CAPD with eosinophilic peritonitis. A 71-year-old female patient developed end-stage renal disease for 4 years and underwent CAPD (2 000 mL of 1.5% dialysis solution with four exchanges daily) for 5 months. With a history of unclean food, she was hospitalized for complaints of diarrhea, fever and cloudy peritoneal effluent for 10 days. Dialysis effluent showed an elevated white blood cell (WBC) count of 1 980 cell/mm³, with 60% polymorphonuclear cells. She was diagnosed as PD-related peritonitis, and therapy was initiated with intraperitoneal ceftazidime 1 g once a day and vancomycin 500 mg every other day. She was admitted to the hospital as the symptoms were not relieved. Her peripheral blood cell count showed a total WBC count of 6 940 cells/mm³, 36.8% eosinophil. Her PD effluent analysis showed turbidity, total WBC count of 1 480 cells/mm³, and 83% polymorphonuclear cells. Her dialysate bacteria culture, fungus culture, polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR), acid-fast stain were all negative. On admission day 4, the treatments were changed to levofloxacin 200 mg once a day and vancomycin 500 mg every other day. After two weeks of antibiotics treatment, patient's symptoms were not completely improved and her dialysis effluent remained cloudy. Her blood eosinophil count elevated to 36.8%，eosinophil proportion in PD effluent>90% and PD effluent pathological findings showed eosinophil>90%. Eosinophilic peritonitis was diagnosed and a decision was made to give loratadine daily dose of 10 mg orally. The possible reasons might be the patient's allergy to some components of PD solution or connection systems in the beginning of PD, and this bacterial peritonitis episode, as well as the application of vancomycin, might lead to the fact that eosinophilic peritonitis acutely developed. For there was no improvement in clinical symptoms, loratadine was stopped, and the patient was discharged 18 days later, and received follow-up closely. Two months later, eosinophil count in blood and PD fluid decreased to normal range with no symptom. This case reminds us that in any PD-related peritonitis patient with prolonged symptoms after appropriate antibiotic therapy, and typical clinical symptoms, the diagnosis of eosinophilic peritonitis should be considered. For the count and percentage of eosinophils are not routinely reported in most laboratories, doctors need to contact the department of laboratory and the department of pathology, to confirm the cell count and proportion of eosinophils in dialysis effluent, so as to make the definite diagnosis, which can not only avoid antibiotics overuse, but also avoid antibiotics-induced eosinophilic peritonitis (such as vancomycin).

[Retrospective study of young bladder urothelial carcinoma from a single center within 16 years]

OBJECTIVE

To evaluate the clinical and pathological features, treatment and prognosis for bladder urothelial carcinoma in relative young patients under 40 years.

METHODS

A retrospective study involved a total of 43 consecutive patients of bladder urothelial carcinoma, which were under 40 years old from January 2001 to December 2016.

RESULTS

The incidence rate of bladder urothelial carcinoma in the patients under 40 years was 2.2%, and 35 males and 8 females were included. The average age was 33 years (ranging from 23 to 40 years). At initial visit, 62.8% of the patients presented with painless gross hematuria, 9 patients were discovered by routine examination, and 7 patients experienced lower urinary tract symptoms. Solitary tumor occurred in 34 cases whereas multiple carcinomas had been discovered in 9 cases，and all the 9 multiple cases were from 31-40-year-old subgroups. All the patients received proper surgical intervention according to their own clinical stages. Post-operative pathological results showed 29 low-grade urothelial carcinoma and 14 high-grade cases which included 31 Ta cases, with 7 cases of T1, 1 case of T3, and 3 cases of T4 and one case of T1 plus Tis. The total follow-up was from 5 to 165 months, 3 cases were lost. The overall recurrence rate was 12.5% (5 cases from 40). One patient developed distal metastasis, one died of metastasis after 13 months, and the other three received secondary trans-urethral resection of bladder tumors. The average recurrence time was 39 months (ranging from 3 to 105 months). The progression rate was 5% among all the followed-up patients (2 cases from 40). The recurrence rate in multiple lesions group (33%, 3/9) was significantly higher than that (5.9%, 2/34) in solitary lesion group (P=0.000 3).

CONCLUSION

The incidence rate of bladder urothelial carcinoma in young patients under 40 years becomes increasingly higher over years. The major initial presentation is painless gross hematuria among these young patients, but lower urinary tract symptoms should also be noticed for young patients to rule out tumor. Postoperative tumor recurrence might be associated with multiple lesions, which is not related to the tumor size or pathological features.

Role of IL-13Rα2 in modulating IL-13-induced MUC5AC and ciliary changes in healthy and CRSwNP mucosa

BACKGROUND

The IL-13 receptor α2 (IL-13Rα2) is a receptor for IL-13 which has conflicting roles in mediating IL-13 responses in the lower airway, with little known about its impact on upper airway diseases. We sought to investigate the expression of IL-13 receptors, IL-13Rα1 and IL-13Rα2, in chronically inflamed nasal epithelium, and explore IL-13-induced signaling pathways in an in vitro model of human nasal epithelial cells (hNECs).

METHODS

The protein and mRNA expression levels of IL-13 and its receptors in nasal biopsies of patients with nasal polyps (NP) and healthy controls were evaluated. We investigated goblet cell stimulation with mucus hypersecretion induced by IL-13 (10 ng/mL, 72 hours) treatment in hNECs using a pseudostratified epithelium in air-liquid interface (ALI) culture.

RESULTS

There were significant increases in IL-13, IL-13Rα1, and IL-13Rα2 mRNA and protein levels in NP epithelium with healthy controls as baseline. MUC5AC mRNA positively correlated with IL-13Rα2 (r = .5886, P = .002) but not with IL-13Rα1 in primary hNECs. IL-13 treatment resulted in a significant increase in mRNA and protein levels of IL-13Rα2 only in hNECs. IL-13 treatment induced an activation of extracellular signal-regulated kinases (ERK)1/2 and an upregulation of C-JUN, where the IL-13-induced effects on hNECs could be attenuated by ERK1/2 inhibitor (50 μmol/L) or dexamethasone (10^-4 -10^-7  mol/L) treatment.

CONCLUSIONS

IL-13Rα2 has a potential role in IL-13-induced MUC5AC and ciliary changes through ERK1/2 signal pathway in the nasal epithelium. IL-13Rα2 may contribute to airway inflammation and aberrant remodeling which are the main pathological features of CRSwNP.

The role of Th1/Th2 cytokines played in regulation of specific CD4 + Th1 cell conversion and activation during inflammatory reaction of chronic obstructive pulmonary disease

CD4 ⁺ Th1-CXCR3 signalling pathway may play a key role in chronic obstructive pulmonary disease (COPD). The aim of this study was to explore Th1/Th2 cytokines ratio differences in patients in different stages of COPD and to confirm the hypothesis that elastin exposure might serve as an antigen to initiate the stimulation of CD4 ⁺ Th1-CXCR3 immune inflammation pathway. Patients of COPD in different stages and normal individuals were enrolled. Ten millilitres of peripheral blood was drawn from patients. The concentration of CXCR3, IFN-γ, IL-2, IL-4 and IL-13 in plasma was detected by ELISA. The Naïve CD4⁺ T cells were isolated from the peripheral blood mononuclear cells, which were stimulated by elastin and collagen before determining the level of IFN-γ secretion by ELISPOT. Compared with control group, the concentration of CXCR3 in the acute exacerbation COPD (AECOPD) group was higher (P < .05). The concentration of IFN-γ and IL-2 in AECOPD group was lower than that in remission (P < .05). The concentration of IFN-γ in the AECOPD and remission was higher than that in controls (P < .05), while IL-2 was opposite (P < .01). The concentration of IL-4 and IL-13 in AECOPD group was higher than that in the controls (P < .05). The CD4⁺ Th1 cells stimulated by the elastin as antigen secreted more IFN-γ than that by collagen (P < .01). CXCR3 was highly expressed in patients with COPD. There were different Th1/Th2 cytokines in different stages of COPD. The CD4+Th1-specific conversion and activation may be an initiator of COPD immune inflammatory response.

The single nucleotide polymorphism rs700518 is an independent risk factor for metabolic syndrome and benign prostatic hyperplasia (MetS-BPH)

Studies have shown that 48.59% of benign prostate hyperplasia (BPH) is combined with metabolic syndrome (MetS). The mainstream view supports the correlation between MetS and BPH, but the pathogenesis of MetS‐BPH is not fully understood. Four hundred and seventy‐four men, aged 47 years or older, were recruited into this study by consecutive routine physical examination programs, and several parameters were obtained from each participant. Based on the diagnosis of BPH, MetS, and MetS‐BPH, the participants were divided into BPH and Non‐BPH groups, MetS and Non‐MetS groups, as well as MetS‐BPH and Non‐MetS‐BPH groups. The values of the obtained parameters were evaluated using Student's t‐test, chi‐square test, and logistic regression analysis. The value of estradiol (E2) was higher in the diseased groups (BPH, MetS, and MetS‐BPH groups) compared with the corresponding control groups (Non‐BPH, Non‐MetS, and Non‐MetS‐BPH groups), and the differences were statistically significant. Also, E2 had an independent association with BPH (OR = 2.286, 95% CI: 1.723–3.593, p < 0.001), MetS (OR = 1.406, 95% CI: 0.585–2.315, p < 0.001), and MetS‐BPH (OR = 1.249, 95% CI: 0.795–1.962, p < 0.001). Regarding SNPs of CYP19A1 gene, both the rs4646 genotypes (CC, CA, and AA) and the rs700518 genotypes (CC, CT, and TT) were present in every group, and all genotypes had statistically significant differences between the diseased and corresponding control groups. However, only the TT genotype of rs700518 was independently associated with BPH, MetS, and MetS‐BPH after adjusting for age. The TT genotype of rs700518 is an independent risk factor for the MetS‐BPH populations, and the CYP19A1 gene regulation of estrogen leads to MetS‐BPH.

Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of northern China

BACKGROUND

The aim of this study was to investigate the prevalence of epidemiologic and physician-diagnosed pollen-induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence.

METHODS

A multistage, clustered and proportionately stratified random sampling with a field interviewer-administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count.

RESULTS

A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05).

CONCLUSION

Pollen-induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.