[The relationship between insulin resistance and risk of long-term mortality in people without diabetes: a 30-year follow-up of the Daqing Diabetes Study]

Objective: To determine whether insulin resistance is associated with all-cause mortality in subjects without diabetes. Methods: A total of 505 participants without diabetes, 198 with normal glucose tolerance (NGT) and 307 with impaired glucose tolerance (IGT), were recruited from the Daqing Diabetes Study. The participants were followed up for 30 years. They were stratified into three groups (tertiles) according to baseline homeostasis model assessment of insulin resistance(HOMA-IR) levels, as the HOMA-IR 0, the HOMA-IR 1 and the HOMA-IR 2 groups, to assess the predictive effect of insulin resistance on risk of all-cause mortality. Results: During the 30-year follow-up, 52, 56 and 78 participants died across the three HOMA-IR groups, respectively. The corresponding mortality per 1 000 person-years (95%CI) were 12.12 (9.56-15.01), 13.10 (10.46-16.03) and 19.91 (16.73-23.15), respectively. Participants in the HOMA-IR 2 group had a significantly higher risk of death than those in the HOMA-IR 0 group after adjustment of age, sex and smoking status (HR=1.97,95%CI 1.38-2.81, P<0.001). Cox analyses showed that a one standard deviation increase in HOMA-IR was associated with a 22% increase in the mortality after adjustment of potential confounders (HR=1.22, 95%CI 1.08-1.39, P=0.002). Conclusions: Insulin resistance is associated with increased risk of all-cause death in Chinese people without diabetes, suggesting that improving insulin resistance could be beneficial for people without diabetic in reducing risk of long-term all-cause mortality.

Effects of Total Flavonoids of Epimedium on Bone Marrow Adipose Tissue in Ovariectomized Rats

Bone marrow adipose tissue has brown fat characteristics. Several studies have demonstrated that total flavonoids of Epimedium (TFE) could prevent bone loss and reduce the white adiposity in bone marrow induced by ovariectomy (OVX) in rats. However, the effects of TFE on marrow brown fat in OVX rats remain unclear. In this word, we addressed this question expected to provide a new target for preventing and treating osteoporosis. Thirty-six 3-month-old female Sprague-Dawley rats were equally divided into Sham controls, OVX controls, and OVX treated with TFE. Chemical shift coding magnetic resonance was performed to detect marrow fat fraction at the left femur at baseline, 6 and 12 weeks post-OVX. Bone mineral density at the lumbar spine and femur was measured by dual-energy x-ray absorptiometry. Serum bone biomarkers by ELISA, trabecular bone microarchitecture at the proximal tibia by micro-CT, quantitative parameters of marrow adipocyte by hematoxylin, and eosin staining were evaluated. The marrow adipocyte gene and protein expressions profile were determined by real-time quantitative PCR and immunostaining in whole tibiae. We found that TFE treatment could decrease bone turnover rate and improved bone mineral density and trabecular microarchitecture in OVX rats. OVX resulted in marrow adipogenesis as evidenced by increased marrow fat fraction, larger marrow adipocyte size, increased adipocyte number and percentage of adipocyte area, marrow white adipocyte gene, and protein expression, including PPARγ2 and FABP4. These pathological changes induced by estrogen deficiency were restored by TFE treatment. TFE also increased brown adipocyte expressions of the transcription factor Ucp1 and Prdm16 in whole tibiae. There was no detectible protein expression of brown adipocyte markers in the proximal tibia. Taken together, TFE regulation of bone marrow adiposity in OVX rats is mediated, at least in part, via maintaining the reciprocity of white and brown adipose tissue.

[Study on the incidence of adult herpes zoster in Yichang city and its association with early-life famine exposure]

Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ (OR=1.21; 95%CI: 1.01-1.45, P=0.041). After stratification by sex, fetal famine exposure was only found to be associated with the onset of adult HZ in females (OR=1.28, 95%CI:1.02-1.61, P=0.034).

[Association analysis of famine exposure during early life and risk of hypertension in adulthood]

Objective: To explore the relationship between exposure to famine in early life and the risk of hypertension in adulthood. Methods: The medical data of Yichang Health Management Big Data Center from 2018 to 2019 were analyzed. A retrospective cohort study design was adopted, with hypertension as the study outcome, and different life periods exposed to the Great Famine in China were divided into groups. Multivariate logistic regression model was used to analyze the relationship between famine exposure in early life and hypertension in adulthood. At the same time, the interaction between gender and famine exposure was analyzed. Results: The age of 142 016 subjects was (60. 56±4.43). Among them, men accounted for 46.36% (65 845/142 016) and women accounted for 53.64% (76 171/142 016). There are 42 575(29.98%), 19 644(13.83%), 28 405(20.00%), 28 305(19.93%), 23 087 (19.93%) in non-famine exposure group, fetal famine exposure group, early childhood famine exposure group and late childhood famine exposure group, respectively. The prevalence of hypertension was 17.57% (24 947 cases). Multivariate logistic regression model analysis showed that after adjusting for related confounding factors, compared with non-famine exposure group, the risk of hypertension in fetal, early childhood, middle childhood and late childhood famine exposure group was higher and the OR (95%CI) values were 1.16 (1.11-1.22), 1.27 (1.21-1.33), 1.54 (1.47-1.60) and 1.84 (1.76-1.92), respectively. There was an interaction between sex and famine exposure group (P<0.001). The above association is stronger among women than among men. Conclusion: Famine exposure in early life may increase the risk of hypertension in adulthood, and the risk of women is greater than that of men.

[Dexmedetomidine up-regulates peripheral blood microRNA 183 to improve remifentanil-related hyperalgesia]

Objective: To investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and its underlying mechanism through a prospective cohort study. Methods: From July 2018 to July 2019, 80 patients who underwent day surgery in Taizhou Central Hospital (including patients with laparoscopic cholecystectomy and oophorocystectomy) were selected, there were 46 males and 34 females with a mean age of (28.8±4.3) years. The patients were divided into dexmedetomidine group and control group with random number table, 40 cases in each group. After anesthesia induction, the dexmedetomidine group was managed with intravenous infusion of dexmedetomidine (1 μg/kg) within 10 minutes, while the control group was treated with an equal volume of normal saline. The patient's general information and the intraoperative data were recorded. The visual analogue scale (VAS) was evaluated before the operation and 1, 6 and 12 h after the surgery. The Von Frey cilia method was conducted to determine the mechanical pain threshold of the patient's non-surgical body parts. The vein blood was extracted at the corresponding time point to evaluate the expression level of miR-183 via the RT-PCR method. The demographic and preoperative parameters were comparable between the two groups. Results: Compared with the control group, the mechanical pain threshold in the dexmedetomidine group increased significantly at 1, 6, and 12 h after surgery (all P<0.05), and the VAS score at the corresponding time point declined significantly (all P<0.05). At the same time points, the serum miR-183 levels in the dexmedetomidine group were all significantly higher than those in the control group after surgery (2.07±0.41 vs 1.68±0.60, 1.99±0.33 vs 1.74±0.54, 1.88±0.36 vs 1.67±0.54, respectively, all P<0.05). Conclusion: A perioperative dose of dexmedetomidine in day surgery can significantly improve the remifentanil-related hyperalgesia, and it may be related to up-regulation of the expression of miR-183 in the blood.

Rapid remission of refractory synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome in response to the Janus kinase inhibitor tofacitinib: A case report

BACKGROUND

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoinflammatory disease for which clinical treatment has not been standardized. Janus kinase (JAK) inhibitors represent a novel therapeutic option for rheumatoid arthritis, psoriatic arthritis, and some other autoinflammatory diseases. However, the clinical utility of JAK inhibitors in treating SAPHO syndrome has not been thoroughly investigated. In this study, we describe a patient with SAPHO syndrome who failed to respond to conventional treatment but demonstrated a remarkable and rapid response to the JAK inhibitor tofacitinib.

CASE SUMMARY

A 62-year-old female patient presented with swelling and pain at the sternoclavicular joints, back pain that limited her activities, arthralgia in the right knee, and cutaneous lesions. Her symptoms were unresponsive to nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, Tripterygium wilfordii hook f, and bisphosphonates. SAPHO syndrome was diagnosed in accordance with dermatological and osteoarticular manifestations and abnormal inflammatory factors. Multiple image studies have illustrated bone lesions and pathological fractures of vertebral bodies. Oral treatment with tofacitinib at 5 mg twice daily with methotrexate and bisphosphonates was initiated. The patient reported that her pain symptoms were relieved after 3 d and her cutaneous lesions were reduced after 4 wk of treatment. Vertebral lesions were improved after 6 mo on tofacitinib. No serious adverse effects were noted.

CONCLUSION

JAK inhibitor therapy may be a promising strategy to treat SAPHO syndrome.

Pectoralis muscle area is associated with bone mineral density and lung function in lung transplant candidates

Loss of bone mineral density and skeletal muscle area are linked in lung transplant patients. This loss is greater in patients with restrictive compared with obstructive lung diseases.

INTRODUCTION

Sarcopenia and osteoporosis are associated with aging and chronic illnesses and may be linked in patients with advanced lung disease. Pectoralis muscle index (PMI) quantitated on computed tomography (CT) of the chest can be used to measure skeletal muscle mass. This study aimed to determine the relationship of PMI to clinical parameters including bone mineral density (BMD) in candidates for lung transplantation.

METHODS

A retrospective review of transplant candidates at a single center was performed. Demographic, anthropomorphic, and clinical data were recorded. Pectoralis muscle area (PMA) was determined on an axial slice from a chest CT. PMI was calculated as the PMA divided by height squared. BMD was obtained from routine dual-energy X-ray absorptiometry (DXA) scan.

RESULTS

In 226 included patients, mean PMI was 8.2 ± 3.0 cm²/m² in males and 6.1 ± 2.1 cm²/m² in females. Osteopenia was present in 44.4%, and 23.2% of patients had osteoporosis. Patients with obstructive lung disease had lower body mass index (22.0 ± 4.9 versus 27.9 ± 4.9 kg/m², p < 0.001), PMI (6.0 ± 2.3 versus 8.2 ± 2.8 cm²/m², p < 0.001), and BMD (- 2.3 ± 1.1 versus - 1.3 ± 1.1, p < 0.001) compared with patients with restrictive lung disease. PMI was a significant predictor of BMD (β = 0.16, p < 0.001).

CONCLUSION

The association between muscle area and BMD in lung transplant candidates suggests that similar mechanisms may underlie the development of both. Differences in PMI and BMD in patients with obstructive versus restrictive lung disease may result from differences in respiratory physiology or disease processes.

[Anatomical study of rat trigeminal motor nucleus-lateral pterygoid muscle projection pathway]

Objective: To determine the opening and closing action of the external muscle, the projection pathway of the axon terminal of trigeminal motor nucleus (Vmo) neuron to the lateral pterygoid muscle was revealed. Methods: In this study, 10 SD rats of 8 weeks old were included. The left lateral pterygoid muscle of SD rats was surgically exposed, and the wound was closed after intramuscular injection of hydroxystilbamidine/fluorogold (FG) 3-5 μl. Seven days after the operation, the experimental animals were perfused, samples collected and sectioned for immunofluorescence staining. After FG injection into the lateral pterygoid muscle, the FG reversed in the Vmo neurons. Results: In the Vmo neurons on the FG injection side (left side), a large number of FG reversed neurons were found in the corpus luteum and dendrites. These neurons were not only distributed in the dorsolateral part of the trigeminal motor nucleus that innervated the closed muscle, but also in the ventral medial portion of the trigeminal nucleus of the open muscle. Conclusions: The neuronal conduction pathway between the Vmo and the lateral pterygoid muscle innervates the lateral pterygoid muscle. The neurons are distributed both in the dorsolateral and in the nucleus of the ventral ventricle. It is concluded that the lateral pterygoid muscle involve in the jaw closing and opening movement.

Oncogenic functions of the EMT-related transcription factor ZEB1 in breast cancer

Zinc finger E-box binding homeobox 1 (ZEB1, also termed TCF8 and δEF1) is a crucial member of the zinc finger-homeodomain transcription factor family, originally identified as a binding protein of the lens-specific δ1-crystalline enhancer and is a pivotal transcription factor in the epithelial-mesenchymal transition (EMT) process. ZEB1 also plays a vital role in embryonic development and cancer progression, including breast cancer progression. Increasing evidence suggests that ZEB1 stimulates tumor cells with mesenchymal traits and promotes multidrug resistance, proliferation, and metastasis, indicating the importance of ZEB1-induced EMT in cancer development. ZEB1 expression is regulated by multiple signaling pathways and components, including TGF-β, β-catenin, miRNA and other factors. Here, we summarize the recent discoveries of the functions and mechanisms of ZEB1 to understand the role of ZEB1 in EMT regulation in breast cancer.

[A randomized controlled study of peramivir, oseltamivir and placebo in patients with mild influenza]

Objectives: To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza. Methods: This was a randomized, double-blind, double-dummy, placebo and positive control, multicenter clinical trial, comparing peramivir trihydrate with oseltamivir and placebo. The inclusive criteria were 15-70 years old, onset within 48 h, positive rapid influenza antigen test, and febrile (>38℃) accompanied with at least two associated symptoms. The severe cases complicated with chronic pulmonary and cardiac diseases, malignancies, organ transplantation, hemodialysis, uncontrolled diabetes, immunocompromised status, pregnancy and coexistence of bacterium infections were excluded. All patients were randomized 2∶2∶1 to receive peramivir, oseltamivir and placebo respectively. The primary endpoint was the disease duration, the secondary endpoints included time to normal axillary temperature and normal living activities, viral response, and adverse effects. Results: Following informed consent, 133 patients were included in this study. Four patients were exclude due to missing medical records, not fitting inclusion or exclusion criteria and poor compliance. A total of 129 patients were finally analyzed, including 49 cases, 54 cases and 26 cases in peramivir group, oseltamivir group and placebo group. The median disease duration were 96 (76, 120) hours, 105 (90,124) hours, and 124 (104, 172) hours in three groups respectively (P>0.05) . The time to normal axillary temperature, normal living activities and viral response were not significantly different in three groups (P>0.05) . Conclusion: The value of antiviral therapy in patients with mild influenza needs to be further determined.

[Subjects with impaired glucose tolerance returned to normal glucose status for six years had lower long-term risk of diabetes: 20 years follow up of Daqing diabetes prevention study]

Objective: To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years. Methods: A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control, and diet, exercise and diet plus exercise groups in a six-year intervention trial in 1986. Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years. Results: Among all the subjects, 41.38% of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years, and had a lower incidence of diabetes than subjects maintained IGT status (46.55% vs. 75.25%). Of note, in the intervention group, the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71% vs. 76.25%) after 20 years. There was high long-term risk for diabetes in the IGT subjects after the adjustment of age, sex and baseline glucose (HR=1.81, 95%CI 1.27-2.58, P=0.001), whereas in the non-intervention group, no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43% vs. 65.22%) after adjusting of the same confounders (HR=1.03, 95%CI 0.45-2.35, P=0.94). Conclusions: IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT. However, this beneficial effect could only be viewed in the intervention group, but not in the non-intervention group.

Analysis of the Differentially Expressed Genes Induced by Cisplatin Resistance in Oral Squamous Cell Carcinomas and Their Interaction

BACKGROUND

Oral squamous cell carcinoma (OSCC) is a solid tumor, which originates from squamous epithelium, with about 400,000 new-cases/year worldwidely. Presently, chemoradiotherapy is the most important adjuvant treatment for OSCC, mostly in advanced tumors. However, clinical resistance to chemotherapy still leads to poor prognosis of OSCC patients. Via high-throughput analysis of gene expression database of OSCC, we investigated the molecular mechanisms underlying cisplatin resistance in OSCC, analyzing the differentially expressed genes (DEGs) and their regulatory relationship, to clarify the molecular basis of OSCC chemotherapy resistance and provide a theoretical foundation for the treatment of patients with OSCC and individualized therapeutic targets accurately.

METHODS

Datasets related to "OSCC" and "cisplatin resistance" (GSE111585 and GSE115119) were downloaded from the GEO database and analyzed by GEO2R. Venn diagram was used to obtain drug-resistance-related DEGs. Functional enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis were performed on DEGs using The Database for Annotation, Visualization and Integrated Discovery (DAVID) software. Protein-protein interaction (PPI) network was constructed by STRING (search tool for recurring instances of neighbouring genes) database. Potential target genes of miRNA were predicted via miRDB, and cBioportal was used to analyze the function and survival of the potential functional genes.

RESULTS

Forty-eight upregulated DEGs and 49 downregulated DEGs were obtained from the datasets, with cutoff as p < 0.01 and |log FC| > 1. The DEGs in OSCC mainly enriched in cell proliferation regulation, and chemokine activity. In PPI network with hub score > 300, the hub genes were identified as NOTCH1, JUN, CTNNB1, CEBPA, and ETS1. Among miRNA-mRNA targeting regulatory network, hsa-mir-200c-3p, hsa-mir-200b-3p, hsa-mir-429, and hsa-mir-139-5p were found to simultaneously regulate multiple hub genes. Survival analysis showed that patients with high CTNNB1 or low CEBPA expression had poor outcome.

CONCLUSIONS

In the OSCC cisplatin-resistant cell lines, NOTCH1, JUN, CTNNB1, CEBPA, and ETS1 were found as the hub genes involved in regulating the cisplatin resistance of OSCC. Members of the miR-200 family may reverse drug resistance of OSCC cells by regulating the hub genes, which can act as potential targets for the treatment of OSCC patients with cisplatin resistance.

The transcriptional STAT3 is a potential target, whereas transcriptional STAT5A/5B/6 are new biomarkers for prognosis in human breast carcinoma

Signal Transducer and Activators of Transcription (STAT) is a set of transcription factors, involved in diverse cellular functions. Evidences from cell lines, mouse models and human tissues implicate these transcription factors in the oncogenesis of breast cancer. However, the diverse expression patterns and prognostic values of 7 STATs remain to be elucidated. In the current study, we mined the transcriptional and survival data of STATs in patients with breast carcinoma (BC) through ONCOMINE, bc-GenExMiner, Kaplan-Meier Plotter and cBioPortal. It was found that STAT1/2 were up-regulated, whereas STAT3/4/5A/5B were down-regulated in BC patients compared with the normal tissues. The expressions of STAT5A/5B/6 were correlated with decreased levels of histological differentiation. In survival analyses through the Kaplan-Meier plotter database, high transcription levels of STAT2/4/5A/5B/6 were associated with better relapse-free survival (RFS) in all BC patients. Conversely, high STAT3 predicted shorter RFS in BC patients, suggesting that STAT3 is potential targets for precision therapy to BC patients. These data also provided STAT5A/5B/6 as new biomarker for BC prognosis.

[Effect of smart-phone application on complications of chemoradiotherapy and quality of life in patients with nasopharyngeal carcinoma]

Objective:To investigate the interventional effect of smart-phone application on development of complications of chemoradiotherapy in patients with nasopharyngeal carcinoma (NPC) after discharge.Method:Sixty-five NPC patients receving first chemoradiotherapy were randomly divided into two groups. Control group including 33 patients, use traditional oral Health education. Intervention group including 32 patients, use a smart-phone application after discharge. The smart-phone application with text and graphics was established to conduct health education and dynamically manage discharged patients for promoting themselves health management. Poisonous side reactions and quality of life of two groups were investigated at discharge and 6 months after discharge.Result:There were not significant difference between two groups on complications of chemoradiotherapy and quality of life at discharge. After discharge 6 months, the incidence of oral mucositis, dry mouth, nasal obstruction and difficulty in opening mouth of intervention group were lower than control group significantly, while the quality of life of intervention group higher than control group significantly (P< 0.05). Conclusion:Smart-phone application can reduce complications of chemoradiotherapy, and improve the quality of life in patients with NPC after discharge.

[Research of the expression of subchondral bone of Indian hedgehog with early experimental osteoarthritis induced by mechanical stress]

Objective: To investigate the the expression of subchondral bone of Indian hedgehog(Ihh) with early experimental osteoarthritis induced by mechanical stress. Methods: The animals were equally divided into two groups: experimental group(E-group, n=15) and control group(S-group, n=15). The right knee joints of E-group underwent surgery, which involved in both medial collateral ligament (MCL) transaction and medial meniscectomy, while the control group was only carried out with a sham operation.The rats were killed at 1, 2 and 4 weeks postsurgery to obtain the right knee joints. Immunostaining and immunofluorescence double staining were performed to evaluate the expression of Ihh in subchondral bone, respectively. Results: The polynuclear giant cells in the subchondral bone of E-Group expressed Ihh in their cytoplasm 1 and 2 weeks post-surgery, except for 4 week, while those of S-Group appeared negative at all three time points postsurgery. There is statistically difference between the mean density of positive area of Ihh in sections of E-group and S-group both in 1 week (E-group: 0.351+ 0.086, S-group: 0.153±0.017, P<0.05) and 2 weeks (E-group: 0.303±0.026, S-group: 0.176±0.013, P<0.05), but without statistically difference in 4 weeks (E-group: 0.092±0.033, S-group: 0.136±0.014, P>0.05) post surgery. Trap positive giant cells in subchondral bone of E-group were also found Ihh positive, which indicated expression of Ihh in osteoclast . Conclusion: Ihh maybe play an important role in pathogenesis of early experimental osteoarthritis.

The associations of vascular endothelial growth factor gene polymorphisms with susceptibility to osteosarcoma: evidence from a meta-analysis

Several studies have investigated the associations of the vascular endothelial growth factor (VEGF) gene polymorphisms with the susceptibility to osteosarcoma, while their conclusions are conflicting. This meta-analysis was performed to provide a comprehensive assessment on those associations. Electronic bibliographic databases were searched for potential studies focused on the relationship between VEGF polymorphisms and the susceptibility to osteosarcoma on 10 December 2015. Pooled odds ratios with 95% confidence intervals were conducted to assess the associations. After strict screening process, six articles consisted of 1220 osteosarcoma patients and 1576 controls were selected. The pooled results suggested that VEGF-2578C/A polymorphism was significantly associated with osteosarcoma risk in all genetic models as well as VEGF-634G/C polymorphism. When it came to VEGF+936C/T polymorphism, we detected significant associations under allele contrast, heterozygote, dominant and recessive models. As to VEFG-460T/C polymorphism, significant associations were demonstrated in allele contrast and heterozygote models. With regard to VEGF-1156G/A polymorphism, significant association was observed only in alleles contrast model. However, there was no significant association between VEGF-1612G/A polymorphism and risk of osteosarcoma. This meta-analysis suggests that these polymorphisms comprised of VEGF-2578C/A, VEGF-1156G/A, VEGF+936C/T, VEGF-634G/C and VEGF-460T/C are associated with osteosarcoma risk in Chinese Han population.

Mining distinct aldehyde dehydrogenase 1 (ALDH1) isoenzymes in gastric cancer

Aldehyde dehydrogenase 1 (ALDH1) consists of a family of intracellular enzymes, highly expressed in stem cells populations of leukemia and some solid tumors. Up to now, 6 isoforms of ALDH1 have been reported. However, the expression patterns and the identity of ALDH1 isoenzymes contributing to ALDH1 activity, as well as the prognostic values of ALDH1 isoenzymes in cancers all remain to be elucidated. Here, we studied the expressions of ALDH1 transcripts in gastric cancer (GC) compared with the normal controls using the ONCOMINE database. Through the Kaplan-Meier plotter database, which contains updated gene expression data and survival information of 876 GC patients, we also investigated the prognostic values of ALDH1 isoenzymes in GC patients. It was found that when compared with normal tissues, ALDH1A1 mRNA expression was downregulated, whereas ALDH1A3 and ALDH1B1 were upregulated in GC patients. In survival analyses, high ALDH1A1 and ALDH1B1 expressions were associated with better overall survival (OS) in all GC patients. In addition, high transcription activity of ALDH1A1 predicted better OS in gastric intestinal type adenocarcinoma, but not in diffuse gastric adenocarcinoma. GC patients with high mRNA level of ALDH1B1 showed better OS in gastric intestinal type, and worse OS in diffuse type. Oppositely, high transcription activities of ALDH1A2, ALDH1A3 and ALDH1L1 predicted worsen overall survival in GC patients, suggesting that these isoenzymes might be responsible mainly for the ALDH1 activities in GC. These data provides ALDH1A2, ALDH1A3 and ALDH1L1 as excellent potential targets for individualized treatment of GC patients.

Influence of early zoledronic acid administration on bone marrow fat in ovariectomized rats

Although the primary target cell of bisphosphonates is the osteoclast, increasing attention is being given to other effector cells influenced by bisphosphonates, such as osteoblasts and marrow adipocytes. Early zoledronic acid (ZA) treatment to ovariectomized (OVX) rats has been found to fully preserve bone microarchitecture over time. However, little is known regarding the influence of ZA on marrow adipogenesis. The purpose of this study was to monitor the ability of early administration of ZA in restoring marrow adiposity in an estrogen-deficient rat model. Thirty female Sprague-Dawley rats were randomly divided into sham-operated (SHAM), OVX + vehicle, and OVX + ZA groups (n=10/group). Dual-energy x-ray absorptiometry and water/fat magnetic resonance imaging were performed at baseline, 6 weeks, and 12 weeks after treatment to assess bone mineral density and marrow fat fraction. Serum biochemical markers, bone remodeling, and marrow adipocyte parameters were analyzed using biochemistry, histomorphometry, and histopathology, respectively. The expression levels of osteoblast, adipocyte, and osteoclast-related genes in bone marrow were assessed using RT-PCR. The OVX rats showed marked bone loss, first detected at 12 weeks, but estrogen deficiency resulted in a remarked increase in marrow fat fraction, first detected at 6 weeks compared with the SHAM rats (all P < .001). Similarly, the OVX rats had a substantially larger percent adipocyte area (+163.0%), mean diameter (+29.5%), and higher density (+57.3%) relative to the SHAM rats. Bone histomorphometry, levels of osteoclast-related gene expression, and a serum resorption marker confirmed that ZA significantly suppressed bone resorption activities. Furthermore, ZA treatment returned adipocyte-related gene expression and marrow adipocyte parameters toward SHAM levels. These data suggest that a single dose of early ZA treatment acts to reverse marrow adipogenesis occurring during estrogen deficiency, which may contribute to its capacity to reduce bone loss.

The temporal characterization of marrow lipids and adipocytes in a rabbit model of glucocorticoid-induced osteoporosis

OBJECTIVE

To characterize the temporal changes in marrow lipids content and adipocytes in the development of glucocorticoid-induced osteoporosis (GIOP) in rabbits using MR spectroscopy.

SUBJECTS AND METHODS

Twenty 20-week-old female rabbits were randomized to a control group and a GIOP group equally. Marrow lipids fraction and bone mineral density at the left proximal femur and L3-L4 vertebrae were measured by MR spectroscopy and dual-energy X-ray absorptiometry at week 0, 4, 8, and 12. Marrow adipocytes were quantitatively evaluated by histopathology.

RESULTS

Marrow adiposity in the GIOP group showed a significant increase over time, with a variation of marrow lipids fraction (+35.9 %) at week 4 from baseline and it was maintained until week 12 (+75.2 %, p < 0.001 for all). The GIOP group demonstrated continuous deterioration of bone with significant difference between the two groups at week 8, followed by increased marrow fat with significant difference at week 4 (p < 0.05 for all). In comparison with the controls, marrow adipocyte density in the GIOP group increased by 57.1 % at week 8 and 35.4 % at week 12, respectively. A reduction (-13.3 %) in adipocyte mean diameter at week 8 (but an increase (+22.7 %) at week 12) were observed in the GIOP group compared with the control group (p < 0.05 for all). There was significant difference between two periods (p = 0.023) in adipocyte mean diameter in the GIOP group. The percentage area of marrow adipocytes in the GIOP group was 62.8 ± 8.7 % at week 8 and 79.2 ± 7.7 % at week 12, both of which were significantly higher than those of the controls (p < 0.05 for all).

CONCLUSIONS

Marrow adipogenesis is synchronized with bone loss in the development of GIOP, which was characterized by a significant increase in the number of small-sized marrow adipocytes in the relatively early stage and concomitant volume increase later on. MR spectroscopy appears to be the most powerful tool for detecting the sequential changes in marrow lipid content.

Characterizing venous vasculatures of hepatocellular carcinoma using a multi-breath-hold two-dimensional susceptibility weighted imaging

The aim of our study is to characterize the venous vasculatures of hepatocellular carcinoma (HCC) using a multi-breath-hold two-dimensional (2D) susceptibility weighted imaging (SWI) in comparison with conventional Magnetic Resonance Imaging (MRI) sequences. Twenty-nine patients with pathologically confirmed HCC underwent MR examination at a 3.0 T scanner. The number of venous vascularity in or around the lesion was counted and the image quality was subjectively evaluated by two experienced radiologists independently based on four image sets: 1) SWI, 2) T1-weighted sequence, 3) T2-weighted sequence, and 4) T1-weighted dynamic contrast-enhanced (DCE) sequence. Of the 29 patients, a total of 33 liver lesions were detected by both SWI and conventional MR sequences. In the evaluation of the conspicuity of venous vascularity, a mean of 10.7 tumor venous vessels per mass was detected by the SWI and 3.9 tumor vasculatures were detected by T1-weighted DCE (P<0.0001), while none was detected by T1-, T2-weighted sequences. The Pearson correlation coefficients between the lesion sizes and the number of tumor vasculatures detected by T1-weighted DCE was 0.708 (P<0.001), and 0.883 by SWI (P<0.001). Our data suggest that SWI appears to be a more sensitive tool compared to T1-weighted DCE sequence to characterize venous vasculature in liver lesions.

Prediction of hip osteoporotic fractures from composite indices of femoral neck strength

OBJECTIVE

To clarify whether composite hip strength indices improve predictive ability for hip osteoporotic fractures independent of conventional bone mineral density (BMD).

SUBJECTS AND METHODS

Three hundred and eighty-two health controls and 43 women with hip fractures (aged 28.2-87.7 years, mean age 59.5 ± 9.2 years) were measured by dual energy X-ray absorptiometry for femoral neck bone mineral density (FN_BMD) and proximal femur geometry parameters of hip, and composite hip strength indices (Compression strength index, Bending strength index, and Impact strength index). The association between the studied parameters and the fractures was modelled using multiple logistic regression, including age, height, weight, and menopausal status. Fracture-predicted probability was calculated for each predictor tested. ROC curve areas (AUCs) were calculated for the fracture status, having the calculated fracture-predicted probability as a test variable. AUCs were compared by the Hanley-McNeil test.

RESULTS

Women with hip fractures had lower FN_BMD, composite hip strength indices, and longer hip axis length than controls, and no significant difference in femoral neck width. Logistic regression showed composite hip strength indices could predict hip fractures risk. To the same extent as FN BMD, Compression Strength Index (CSI) best predicted the risk for each fracture (AUC = 0.787 ± 0.028). When CSI was added to FN_BMD, there was a small but not statistically significant increase in AUC to 0.796 ± 0.027 (P = 0.9018).

CONCLUSION

Composite indices of femoral neck strength may be valuable in the assessment of the biomechanics of bone fragility; however, they do not appear to add diagnostic value to the simple measurement of BMD.

Marrow adiposity recovery after early zoledronic acid treatment of glucocorticoid-induced bone loss in rabbits assessed by magnetic resonance spectroscopy

BACKGROUND

Although there is an inverse relationship between bone mass and marrow adiposity, the reversal function of zoledronic acid (ZOL) on increased marrow fat has not been studied. The aim of our study is to use the 3T magnetic resonance spectroscopy (MRS) to characterize the dynamical change process of the marrow fat responding to early ZOL treatment in the rabbit model with glucocorticoid-induced bone loss.

METHODS

Fifteen 20-week-old female New Zealand White rabbits were randomized to control group, methylprednisolone (MPS) group, and MPS+ZOL group equally. Bone mineral density (BMD) and marrow fat fraction (FF) at L3-L4 vertebrae and left proximal femur were measured by Dual-energy X-ray absorptiometry and MRS at week 0, 4, 8, and 12. The animals were euthanized at the end of our experiment and their left femurs were dissected out for the histopathological examination.

RESULTS

The MPS group demonstrated a remarkable increase in FF but a reduction in BMD compared with the controls at week 4 and 8, respectively (P<0.05 for all). Early treatment of ZOL can inhibit bone degeneration, although the bone mass would not recover to its original level. FF in MPS group exhibited a dramatic increase over time, with an increased FF variation (+31.6%, P=0.009) at week 4 from baseline and it was maintained until week 12 (+75.2%, P<0.001). In MPS+ZOL group, the FF returned to baseline value after the ZOL treatment. Comparing with the controls, larger marrow adipocyte density, the mean of the adipocyte diameter, and the percentage area of the adipocyte were observed in the MPS group (P<0.05 for all), whereas there were no significant differences in quantitative parameters of marrow adipocytes between the ZOL-treated group and the normal rabbits.

CONCLUSION

An increase of the marrow adiposity is synchronized with the deterioration of the MPS-induced bone mass. A single dose of early ZOL can reverse the marrow adiposity to its original level completely.

Treatment of Short Gut Syndrome With Early Living Related Small Bowel Transplantation

AIM

To investigate the results of treating short bowel syndrome with an early living related small bowel transplantation (SBT).

METHODS

A 17-year-old boy with a 20-cm-long residual intestine due to necrotic volvulus received an early living related SBT from his mother. Donor-specific blood transfusion was performed for 8 weeks before transplantation, each time for 50 mL every week. Cytomegalovirus status in both donor and recipient was negative. A 160-cm distal ileal segment was removed from the donor. The graft ilecolic artery and vein were anastomosed to the recipient's infrarenal aorta and caval vein. The proximal end of the graft was anastomosed end-to-end to the residual recipient jejunum; the distal anastomosis, between the distal end of the graft and transverse colon. An ileostomy was also performed. Immunosuppression, infection prophylaxis, and antithrombotic and nutrition support were given postoperatively.

RESULTS

The donor had an uneventful recovery. No technical complications were observed. The recipient was alive and well at 31 weeks after the operation. No graft rejection or infection was observed. He was off TPN 8 weeks after the operation and took low-fat food. The D-xylose test in the recipient was almost normal.

CONCLUSIONS

Early living related small intestine transplantation is a good treatment for short bowel syndrome.

Use of biological activated carbon to treat mixed gas of toluene and benzene in biofilter

The biodegradation of toluene and benzene in a biofilter filled with cylindrical activated carbon was studied. Three various gaseous flow rates, i.e. 0.25, 0.50 and 0.75 m3 h(-1), corresponding to empty bed gas residences of 75, 37.5 and 25 s, respectively, and total organic load lower than 400 g m(-1) h(-1) were tested. The biofilter proved to be highly efficient in biodegradations of toluene and benzene, and toluene was more easily degraded than benzene. When each inlet load of toluene and benzenewas lower than 150 g m(-3) h(-1), removal rate increased with inlet loads and reached maximum values of 150 and 120 g m(-3) h(-1) for toluene and benzene, respectively. For inlet load higher than the maximum removal capacity conditions, the removal rate decreased with inlet load. The carbon dioxide concentration profile through the biofilter revealed that the mass ratios of carbon dioxide produced to the toluene and benzene removed were 2.15 g CO2 g(-1) toluene and 1.67 g CO2 g(-1) benzene. Model predictions for toluene, benzene and carbon dioxide concentration gradient profiles were in agreement with experimental data for the tested conditions. The observation of biotic community demonstrated that the microbes consisted of bacillus, spore bacillus and fungi, of them spore baxillus was dominant.

Biological treatment characteristics of benzene and toluene in a biofilter packed with cylindrical activated carbon

The biodegradation of toluene and benzene in a biofilter using cylindrical activated carbon as the filler materials was studied. Three gas low rates, i.e. 0.25, 0.50 and 0.75 m3/h, corresponding to empty bed gas residence of 75, 37.5 and 25 s, respectively, and total organic load lower than 400 g/m3 x h were tested. The biofilter proved to be highly efficient in biodegradation of toluene and benzene, and toluene was more easily degraded than benzene. When each inlet load was lower than 150 g/m3 x h, removal rate increased with inlet load and reached a maximum, which was 150 and 120 g/m(-3) x h for toluene and benzene, respectively. For inlet load higher than the maximum removal capacity conditions, the removal rate decreased with inlet load. Carbon dioxide concentration profile through the biofilter revealed that the mass ratios of carbon dioxide produced to the toluene and benzene removed were 2.15 g(CO2)/g(toluene) and 1.67 g(CO2)/g(benzene), which furthermore, confirmed the biodegradation performance in biofilter. The observation of biotic community demonstrated that the microbes consisted of bacillus, spore bacillus and fungi, of which the spore bacillus was dominant.

[Effects of short interval successive partial hepatectomy on ACP, AKP, HSC70/HSP68 and PCNA in rat liver]

In this paper, the models of 36-4-4 SISPH and 4-36-36-36 SISPH were used to analyze the changes of activity and content of ACP, AKP, HSC70/HSP68 and PCNA in rat liver. The results showed that the activities of 140 kD ACP and AKP in SISPH were increased following the increase of SISPH number of times, but that of 160 kD ACP and AKP were decreased following the increase of SISPH number of times. The content of PCNA in 4-36-36-36 SISPH were more than that in 36-4-4 SISPH, in contrast for HSC70/HSP68 in these two models. Therefore, the content and activities of ACP, AKP, HSC70/HSP68 and PCNA could be strongly effected by SISPH number of times and SISPH methods. Its mechanisms and physiological significance were discussed.

[Research progress in gene engineered antibodies]

Gene engineered antibodies(GEAs) have been applied in a lot of aspects with the great development of the technique of GEAs. The technique of GEAs such as ribosome display and phage surface display and their application progress were summarized in this review.

Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group

OBJECTIVE

To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and its risk factors in the Chinese population.

RESEARCH DESIGN AND METHODS

This study was a population-based cross-sectional study of 224,251 residents aged 25-64 years in 19 provinces and areas, including cities and rural areas of the north, south, east, and middle part of China.

RESULTS

Using the 1985 World Health Organization criteria, the prevalence of diabetes and IGT was 2.5 and 3.2%, respectively, in 213,515 subjects aged 25-64 years. Two thirds (70.3%) of the cases had newly recognized diabetes. The prevalence of diabetes in China is about three times higher than it was 10 years ago. On average, subjects with diabetes are older, have higher personal annual incomes, and more often have a family history of diabetes. They also have higher mean BMI, waist-to-hip ratio (WHR), systolic blood pressure, diastolic blood pressure, and a greater prevalence of hypertension. They perform less physical activity and have less education than people with normal oral glucose tolerance test results. Multiple logistic stepwise regression analysis shows that age, BMI (or WHR), family history of diabetes, hypertension, less physical activity, and higher annual income are independent risk factors of NIDDM, and that low education is also an independent risk factor of NIDDM in people with higher personal annual income.

CONCLUSIONS

The prevalence of diabetes in China is increasing with economic development and changes from traditional to modernized lifestyle, especially where people had lower level of education and socioeconomic development. Therefore, Chinese people should attempt to retain certain features of their traditional lifestyle (physical activity, healthy food, moderate body weight). Increased knowledge of risk factors for diabetes may help to prevent a further rapid increase in the prevalence of diabetes in China.

Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study

OBJECTIVE

Individuals with impaired glucose tolerance (IGT) have a high risk of developing NIDDM. The purpose of this study was to determine whether diet and exercise interventions in those with IGT may delay the development of NIDDM, i.e., reduce the incidence of NIDDM, and thereby reduce the overall incidence of diabetic complications, such as cardiovascular, renal, and retinal disease, and the excess mortality attributable to these complications.

RESEARCH DESIGN AND METHODS

In 1986, 110,660 men and women from 33 health care clinics in the city of Da Qing, China, were screened for IGT and NIDDM. Of these individuals, 577 were classified (using World Health Organization criteria) as having IGT. Subjects were randomized by clinic into a clinical trial, either to a control group or to one of three active treatment groups: diet only, exercise only, or diet plus exercise. Follow-up evaluation examinations were conducted at 2-year intervals over a 6-year period to identify subjects who developed NIDDM. Cox's proportional hazard analysis was used to determine if the incidence of NIDDM varied by treatment assignment.

RESULTS

The cumulative incidence of diabetes at 6 years was 67.7% (95% CI, 59.8-75.2) in the control group compared with 43.8% (95% CI, 35.5-52.3) in the diet group, 41.1% (95% CI, 33.4-49.4) in the exercise group, and 46.0% (95% CI, 37.3-54.7) in the diet-plus-exercise group (P < 0.05). When analyzed by clinic, each of the active intervention groups differed significantly from the control clinics (P < 0.05). The relative decrease in rate of development of diabetes in the active treatment groups was similar when subjects were stratified as lean or overweight (BMI < or > or = 25 kg/m2). In a proportional hazards analysis adjusted for differences in baseline BMI and fasting glucose, the diet, exercise, and diet-plus-exercise interventions were associated with 31% (P < 0.03), 46% (P < 0.0005), and 42% (P < 0.005) reductions in risk of developing diabetes, respectively.

CONCLUSIONS

Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT.

Lens epithelial cell mRNA. III. Elevated expression of macrophage migration inhibitory factor mRNA in galactose cataracts

A lens epithelial (LE) cell cDNA clone, designated Clone 156, was isolated from a mature rat LE cDNA library by methods of subtractive hybridization. The cDNA sequence of Clone 156 was 521 nucleotides in length, excluding the poly(T)-tail, and it encoded an open reading frame of 115 amino acids. The translated protein shared extensive sequence similarities with macrophage migration inhibitory factor (MIF) from mouse lens and human T-cell lymphocytes. Northern blot hybridization showed that rat lens MIF mRNA is about 500 nucleotides in length and that its expression in mature rat lens is relatively low in comparison with that in other rat tissues. The expression of MIF mRNA in LE of normal rats and of rats treated by feeding a diet of 50% (w/w) galactose was studied by quantitative RT-PCR. The results showed that the expression of MIF mRNA in a 20-day galactosemic rat LE increased twelvefold as compared to that found in control LE. From the results of this study and from what we know about the locale of epithelial cell differentiation in mature rat lenses, it is being proposed that the increase in abundance of MIF mRNA in the cataractous rat lens is correlated with the enhanced proliferation of the undifferentiated epithelial cells.

Lens epithelial cell mRNA, II. Expression of a mRNA encoding a lipid-binding protein in rat lens epithelial cells

A lens epithelial (LE) cell cDNA clone, designated pLELBP, was isolated by subtraction-hybridization methods between a 4-week-old rat LE cell and rat lens fiber cell lambda ZAP cDNA libraries. The cDNA contained 683 bp, an ATG at bp 42, and an open reading frame (ORF) encoding a protein of 135 amino acids (aa), and a poly(A) signal at bp 641 (GenBank/EMBL accession No. U13253). Northern blot analysis showed that the lens mRNA was at a concentration that exceeded 100-fold that found in non-ocular tissues examined, except in skin it was found at levels equal to about 1/15 of the lens levels. In the retina, it was also found at about 1/15 of that present in the lens. By in situ hybridization analysis, the sense RNA was localized to the LE cells and to the glial cells of the retina, and negligibly to the lens fiber cells. Search of GenBank, EMBL and SwissProt data bases revealed that the LE cell mRNA and its aa encoded protein showed extensive sequence homology to members of the cytosolic lipid-binding protein (LBP) family. It matched to 91% in aa sequence homology to the protein encoded by ORF of mal1 cDNA, isolated from mouse skin squamous cell carcinoma [Krieg et al., J. Biol. Chem. 268 (1993) 17362-17369], and 99% in aa sequence homology to the protein encoded by ORF of rat skin LBP mRNA [Watanabe et al., Biochem. Biophys. Res. Commun. 200 (1994) 253-259]. Occurrence of high levels of mRNA for a specific LBP in the LE cells relative to other non-ocular tissues is consistent with a hypothesis that the encoded protein may be involved in several lens epithelial cell-specific mechanisms, possibly including differentiation, protective and nutritional processes.

Lens epithelial cell mRNA. I. Cloning and sequencing of a messenger RNA with a basic motif/leucine-rich domain specifically expressed in rat lens epithelial cells

By methods of subtraction-hybridization of lambda ZAP cDNA libraries, prepared from 4-week-old rat lens epithelial cells (capsule) and lens fiber cells (decapsulated lens), we have isolated a specific cDNA clone whose target mRNA is about 600 b long. Northern blot hybridization analysis data showed that the target mRNA was preferentially expressed in the lens epithelial cells; it was not found in the retina or in non-ocular tissues. The complete sequence of the mRNA was obtained both by the 5' and 3' rapid amplification of cDNA ends (5'-RACE, 3'-RACE), and by sequencing of a clone containing the full-length cDNA insert. It contains 599 b. with an open reading frame at nucleotide (nt) 30 (ORF30). The base sequence appears to represent a complete sequence of the target mRNA, with a poly(A) signal at nt 563-569, and a poly(A) tail at nt 582 (GenBank accession #U15149). In situ hybridization showed that the target mRNA was localized in the anterior epithelial cells, and in the elongating cells in the bow region. The encoded protein of 57 amino acids (aa) contains a basic and an acidic domain. It is rich in leucine, which is located at the basic region of the ORF at every fourth aa, and at the acidic region at eight aa intervals. Therefore, there is a periodicity in the appearance of leucine residues in the deduced primary sequence, as has been seen in DNA binding proteins. Search of GenBank, EMBL and Swiss-Prot did not yield significant homology to any of the entered sequences in those databanks. Our data demonstrate that we have isolated a cDNA clone containing novel sequences specifically expressed in lens epithelial cells.

[Essential hypertension: a predictor of the 6 year-incidence of NIDDM in 465 non-diabetics]

The effect of essential hypertension at baseline on the development of NIDDM within 6 years was investigated in 465 Chinese nondiabetics with or without hypertension. The age, sex adjusted 6 year incidence of NIDDM in hypertensive group (BP > 18.7 +/- 12. okPa (140/90 mmHg) or treated with antihypertensives) at baseline was significantly higher than that in normotensive group (44.6%, n = 325, P < 0.05) at baseline. Multivariate regression analysis showed the hypertensive group had higher risk of worsening to diabetes compared with normotensives (OR: 1.82, 95% Ci: 1.03-3.21, P < 0.05) after the adjustment for two other important risk factors for NIDDM, the fasting plasma glucose and BMI. Further more the increasement of SBP by 20 mmHg at baseline significantly increase the risk for NIDDM in the followup period in the blood-lowering-drug-free group (OR: 1.54, 95% Ci: 1.05-2.24, P < 0.05). Thus it confirmed that hypertension at baseline was an independent predictor for NIDDM. In addition, our observation showed that some antihypertensive drugs appears also to play an unfavorable role in the occurrence of NIDDM.

[Relationship between obesity and risk factors of coronary heart disease in nondiabetics]

We analysed the data of 395 nondiabetic obese (BMI 25-42.2, impaired glucose tolerance, IGT, 257 and normal glucose tolerance, NGT, 138) and 482 nonobese subjects (BMI 15.9-24.9, IGT 170 and NGT 312). The blood pressure, plasma glucose, insulin, triglyceride and total cholesterol in obese were higher than that in nonobese, while HDL-c level was lower after controlling for age and sex (P < 0.001). This difference remained to be significant even after the adjustment of age, sex, insulin and 2-hours plasma glucose. Therefore, it was suggested that obesity was easy of access to coronary heart disease risk factors independent of hyperglycemia and hyperinsulinemia.

[A new insulin-sensitivity index for the population-based study]

This paper suggests a new simple insulin-sensitivity index, the reverse of fasting plasma glucose and insulin product, which is significantly correlated with the insulin-sensitivity index determined by euglycemic insulin clamp technique (insulin mediated glucose disposal rate, M value) in 320 subjects of Americans including two races (r > 0.7, P = 0.0001). The analysis of 874 cases Chinese showed that the insulin-sensitivity (IS) evaluated by this new index in Chinese was similar to that determined by insulin clamp in Americans: If the IS in subjects with normal glucose tolerance defined as 1.0, then the IS in subjects with impaired glucose tolerance in Chinese and in Americans was 0.61, 0.62 (Pima Indians), 0.71 (Caucasians) and in diabetic Chinese and Americans was 0.57 and 0.53 (Pima Indians and Caucasians) respectively. Thus, it indicated this new index is fit for the evaluation of IS in Chinese population.

[Association between insulin and blood pressure in relation to the influence of body mass index]

The relationship between plasma insulin level and systolic blood pressure (SBP) was investigated by multiple linear regression procedure in 410 Chinese non-diabetics. The significant positive correlation between SBP and 2-hour plasma insulin (INS 2h) after 75g glucose load was found in the BMI (body mass index) 15.9-27.0 group (n = 287) after the adjustment for age, sex, BMI, smoking and plasma cholesterol (P = 0.01). However, this significant correlation was gradually diminished with the expansion of the BMI range, ie. P = 0.04 in the BMI 15.9-29.0 (n = 356) group, P = 0.07 in the BMI 15.9-31 (n = 389) group, and P = 0.12 in the BMI 15.9-33 (n = 402) group after the same adjustment of variables. Interestingly, the significant inverse correlation between insulin-BMI interaction term (product of BMI and insulin) and SBP was found (P = 0.04) in the presence of the significant positive correlation between 2-hour plasma insulin and SBP (P = 0.02) after adjustment of the above mentioned five factors in the whole group (BMI 15.9-42.2, n = 410). These results indicated that SBP is independently correlated with plasma insulin level in the studied population, and that the severer obesity may interfere the net effects of insulin on the elevating of blood pressure.

[Incidence of NIDDM in Daqing and forecasting of NIDDM in China in 21st century]

Based on the survey of the prevalence of NIDDM in 110 660 people aged 25-74 in 1986, the incidence of NIDDM was investigated in 1990 in 36 471 people (M/F 18,801:17,670) who had normal glucose tolerance and/or plasma glucose concentration less than 6.7 mmol/L 2-hour after breakfast (carbohydrate 80 g) four years ago in Daqing, Heilongjiang province, northeast China. 103 male and 88 female diabetics were diagnosed among the 36 471 subjects from June 1986 to June 1990. This result showed that the annual incidence of NIDDM in this area is 131/100,000 (137 in males, 125 in females), and is 130/100,000 standardized to the 1982's chinese population (95% confidence interval, 94-168/100,000). We may estimate that there would be 754 thousand new diabetics per year in 25-74 years old Chinese if the total population were 1.3 billion in China in the 21st century.

Impaired glucose tolerance and its relationship to ECG-indicated coronary heart disease and risk factors among Chinese. Da Qing IGT and diabetes study

OBJECTIVE

To determine the prevalence of IGT and diabetes and identify the occurrence of CVD and its risk factors.

RESEARCH DESIGN AND METHODS

This study was a population-based, cross-sectional study of 110,660 residents, 25-74 yr of age of DaQing, Hei Long Jiang Province, China.

RESULTS

Using 1985 WHO criteria, 577 (5.5/1000) subjects with IGT and 630 (6.0/1000) with newly diagnosed diabetes were identified. In addition, 190 (1.7/1000) with previously known diabetes were identified. Hypertension, obesity, and abnormal albumin excretion were twice as frequent in those with IGT as in 279 men and 240 women of similar age and sex distribution who had normal OGTTs. Plasma cholesterol and TGs were higher, and HDL cholesterol was lower in subjects with IGT than in nondiabetic subjects. Those with IGT had a prevalence of electrocardiographically recognized CHD 9.5-fold greater than the normoglycemic subjects. Subjects with IGT had higher plasma insulin concentrations, but the 1-h insulin-glucose ratio after the 75-g glucose load was lower. In a forward stepwise multiple logistic regression analysis, IGT itself remained an independent factor associated with CHD after adjustment for age, sex, cigarette smoking, plasma cholesterol, BP, and obesity.

CONCLUSIONS

Therefore, in China, IGT may occur with almost as high a frequency as diabetes and is accompanied by an increased frequency of CVD and its risk factors. Estimates from this study indicate that > 12.0% of all ECG-indicated CHD in the Da Qing population occurs in individuals with IGT and NIDDM. The IGT subjects identified in this survey form the cohort for a long-term follow-up and intervention study.

Hemiparkinsonism in monkeys following unilateral common carotid artery infusion of MPTP. A study of behavior, biochemistry and histology

After local surgical exposure, we administrated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) directly into the right common carotid artery of 5 rhesus monkeys. All the monkeys manifested akinesia, rigidity and postural tremor of the contralateral limbs, and spontaneous circling toward the MPTP treated side. These disturbances began to appear 3-4 days after injection, peaking at one month, and continued until the day of sacrifice. After treatment with madopar and apomorphine, marked improvements of the motor impairments appeared and a striking reversal of the direction of rotation away from the MPTP-treated side occurred in a dose-dependent manner. The ipsilateral neurotoxicity was confirmed biochemically by 99% reduction in the caudate-putamen dopamine levels and histologically by selective cell loss in the substantia nigra of the MPTP-treated side. It is concluded that this primate model of hemiparkinsonism is easy to reproduce and life is maintained with good health otherwise. So it may be more feasible for behavioral and pharmacological studies of Parkinson's disease.

Coronary heart disease and diabetic retinopathy in newly diagnosed diabetes in Da Qing, China: the Da Qing IGT and Diabetes Study

In 1986, 110,660 of 281,589 residents aged 25-74 years in Da Qing, Hei Long Jiang Province of China, were surveyed. Based on the results of a 75-g oral glucose tolerance test, 630 subjects were found to have previously undiagnosed diabetes according to 1985 WHO criteria. Among them, 600 diabetics aged 35-74 years (288 men, 312 women) and 410 non-diabetics of similar age with normal glucose tolerance (207 men, 203 women) were examined to determine the prevalence of retinopathy and coronary heart disease (CHD) and to evaluate associated characteristics. Retinal examinations of 423 newly diagnosed diabetics showed that 15.4% had several microaneurysms and/or small intraretinal haemorrhage, 5.5% soft exudates, 7.1% hard exudates, and 2.3% proliferative retinopathy. Among 220 non-diabetics, 13.6% had one or two microaneurysms and/or small intraretinal haemorrhage, and only 1.4% had a few soft exudates; half of the non-diabetics with retinopathy had hypertension. CHD, according to Minnesota coding (1.1-1.3, 5.1-5.3 and 7.1) of resting electrocardiograms, was ten times more frequent in the diabetics (3.59%) than in the controls (0.32%), after adjusting for age and sex. Multiple regression analysis showed that plasma glucose concentration was a risk factor for retinopathy after adjusting for age, sex, body mass index (BMI), smoking and blood pressure. Two-hour plasma glucose concentration (after adjusting for age, sex, BMI, smoking and blood pressure) and blood pressure (after adjusting for age, sex BMI, smoking and 1-h or 2-h plasma glucose level) were associated with CHD among the diabetics and non-diabetics and among the diabetics alone. Thus, both micro- and macrovascular complications occur frequently in previously undiagnosed Chinese diabetics and the frequency of CHD is markedly increased compared to the low frequency among Chinese non-diabetics.

[Continuous ambulatory peritoneal dialysis treatment and blood glucose control in diabetics with end-stage diabetic nephropathy]

6 patients with end-stage diabetic nephropathy were treated with continuous ambulatory peritoneal dialysis (CAPD). The results showed that CAPD is a safe and effective therapeutic method for elderly uremic diabetics even with congestive heart failure or acute myocardial infarction. We also compared the insulin dosages and blood glucose levels in these patients treated with three routes of insulin administration. Good control of blood glucose was obtained by giving insulin subcutaneously or through dialysis tubes.